Individual provider Active NPI

Brian Welch, PSY.D.

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1669623252
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS017885 Issued in PA
Practice address
1315 Walnut St Ste 1700
Philadelphia, PA 19107-4717
Phone
(267) 702-4747
NPI assigned
Oct 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS017885 PA Primary
Clinical Psychologist 103TC0700X 019683 NY

Addresses

Primary practice location

1315 Walnut St Ste 1700
Philadelphia, PA 19107-4717

Mailing address

1315 Walnut St Ste 1700
Philadelphia, PA 19107-4717
Phone (267) 702-4747

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
PS017885PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1669623252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 WALNUT ST STE 1700",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074717",
            "telephone_number": "267-702-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 WALNUT ST STE 1700",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074717",
            "telephone_number": "267-702-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "BRIAN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-01",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017885",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019683",
            "primary": false
        }
    ],
    "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 Jun 30, 2022; 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.