NPIMap

Organization Active NPI

Sri Psychological Services, PC

Doing business as SRI Psychological Services

  • Psychologist
  • Jenkintown, PA
National Provider Identifier
1730259904
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SRI PSYCHOLOGICAL SERVICES, PC
Doing business as
SRI Psychological Services
Practice address
261 Old York Rd Ste 318
Jenkintown, PA 19046-3709
Phone
(215) 885-3337
Fax
(215) 885-3090
NPI assigned
Nov 8, 2006
Last updated
Jan 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Sion Fogal
Title
Payroll Manager
Phone
(215) 885-3337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

261 Old York Rd Ste 318
Jenkintown, PA 19046-3709

Mailing address

261 Old York Rd Ste 318
Jenkintown, PA 19046-3709
Phone (215) 885-3337

Other practice location 1

2824 Cottman Ave Ste 19
Philadelphia, PA 19149-1400
Phone (215) 885-3337

Other names 1

  • SRI Psychological Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040722000333 PA Part B Supplier - Clinic/Group Practice 1456331214 Receives reassigned benefits from 45 practitioners
Practice locations: Jenkintown, PA

National Provider Directory

National Provider Directory

Locations

93 York Rd
Ste 200
Jenkintown, PA 19046
Phone (215) 885-3372

2824 Cottman Ave
Ste 19
Philadelphia, PA 19149

9733 Bustleton Ave
Ste 2N
Philadelphia, PA 19115
Phone (215) 887-7616

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1730259904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 318",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463709",
            "telephone_number": "215-885-3337",
            "fax_number": "215-885-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 318",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463709",
            "telephone_number": "215-885-3337",
            "fax_number": "215-885-3090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2824 Cottman Ave Ste 19",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191491400",
            "country_code": "US",
            "telephone_number": "215-885-3337",
            "fax_number": "215-885-3090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SRI PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "FOGAL",
        "authorized_official_first_name": "SION",
        "authorized_official_title_or_position": "PAYROLL MANAGER",
        "authorized_official_telephone_number": "215-885-3337"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRI Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.