Organization Active NPI

Integral Psychology LLC

  • Clinical Psychologist
  • Bellefonte, PA
National Provider Identifier
1518509066
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
INTEGRAL PSYCHOLOGY LLC
Practice address
111 S Spring St
Bellefonte, PA 16823-1335
Phone
(814) 380-9392
Fax
(814) 470-4160
NPI assigned
Oct 16, 2019
Last updated
Jan 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Durst, PHDNPI 1821521493
Title
Licensed Psychologist
Phone
(814) 380-9392

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

111 S Spring St
Bellefonte, PA 16823-1335

Mailing address

119 Amberleigh LN Ste 119
Bellefonte, PA 16823-8488
Phone (814) 380-9392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200403000321 PA Part B Supplier - Clinic/Group Practice 1951730498 Receives reassigned benefits from 3 practitioners
Practice locations: Bellefonte, PA

National Provider Directory

National Provider Directory

Locations

119 Amberleigh Ln
Bellefonte, PA 16823

119 Amberleigh Ln
Ste 119
Bellefonte, PA 16823
Phone (814) 380-9392

119 Amberleigh Ln
Ste 19
Bellefonte, PA 16823
Phone (814) 380-9392

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1518509066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBERLEIGH LN STE 119",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168238488",
            "telephone_number": "814-380-9392",
            "fax_number": "814-470-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S SPRING ST",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168231335",
            "telephone_number": "814-380-9392",
            "fax_number": "814-470-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "DURST",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "814-380-9392",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefonte, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.