Individual provider Active NPI

George Francis Collins, PSY. D.

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1639360092
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016117 Issued in PA
Practice address
561 Fairthorne Ave
Philadelphia, PA 19128-2412
Phone
(215) 487-4000
NPI assigned
Aug 9, 2007
Last updated
May 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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 PS016117 PA Primary

Addresses

Primary practice location

561 Fairthorne Ave
Philadelphia, PA 19128-2412

Mailing address

561 Fairthorne Ave
Philadelphia, PA 19128-2412
Phone (215) 487-4000

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

State licenses

LicenseStateTypeSpecialty
PS016117PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1639360092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 FAIRTHORNE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282412",
            "telephone_number": "215-487-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 FAIRTHORNE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282412",
            "telephone_number": "215-487-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "GEORGE",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.