NPIMap

Organization Active NPI

MG Therapeutic Services LLC

  • Clinical Psychologist
  • Media, PA
National Provider Identifier
1649747866
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MG THERAPEUTIC SERVICES LLC
Practice address
100 W Sixth St Ste 305
Media, PA 19063-2428
Phone
(484) 445-4147
NPI assigned
Oct 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Authorized official

Name
Dr. Mattthew Paul Richmond, PSY.D.
Title
Staff Psychologist
Phone
(847) 421-0122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

100 W Sixth St Ste 305
Media, PA 19063-2428

Mailing address

100 W Sixth St Ste 305
Media, PA 19063-2428

National Provider Directory

National Provider Directory
Tax ID family
MG Therapeutic Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 W Sixth St
Ste 305
Media, PA 19063
Phone (484) 445-4147

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1649747866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W SIXTH ST STE 305",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W SIXTH ST STE 305",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632428",
            "telephone_number": "484-445-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MG THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "RICHMOND",
        "authorized_official_first_name": "MATTTHEW",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "STAFF PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-421-0122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.