NPIMap

Organization Active NPI

Philly Psychology LLC

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1750991949
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PHILLY PSYCHOLOGY LLC
Doing business as
Philly Psychology LLC
Practice address
255 S 17TH St Ste 1106
Philadelphia, PA 19103-6212
Phone
(267) 712-9217
NPI assigned
Aug 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Dr. Valerie Braunstein, PSYDNPI 1689085516
Title
Psychologist
Phone
(267) 712-9217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

255 S 17TH St Ste 1106
Philadelphia, PA 19103-6212

Mailing address

255 S 17TH St Ste 1106
Philadelphia, PA 19103-6212
Phone (267) 712-9217

Other names 1

  • Philly Psychology LLC Doing business as

National Provider Directory

National Provider Directory

Locations

255 S 17th St
Ste 1106
Philadelphia, PA 19103
Phone (267) 225-4868

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1750991949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 1106",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036212",
            "telephone_number": "267-712-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 1106",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036212",
            "telephone_number": "267-712-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "BRAUNSTEIN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "267-712-9217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philly Psychology LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 3, 2020; 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.