Individual provider Active NPI

Alexander Adam Puhalla, PHD

  • Clinical Psychologist
  • Coatesville, PA
National Provider Identifier
1609448729
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS019309 Issued in PA
Practice address
1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040
Phone
(610) 384-7711
NPI assigned
Jul 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS019309 PA Primary

Addresses

Primary practice location

1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040

Mailing address

2967 W School House LN Apt 906
Philadelphia, PA 19144-5209
Phone (570) 335-7936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS019309PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1609448729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2967 W SCHOOL HOUSE LN APT 906",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445209",
            "telephone_number": "570-335-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BLACKHORSE HILL RD",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193202040",
            "telephone_number": "610-384-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUHALLA",
        "first_name": "ALEXANDER",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coatesville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.