Active NPI
Robert Joseph Palladino Jr., M ED
- Psychologist
- Glen Mills, PA
National Provider Identifier
1780778720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS005852L
- Practice address
- 1204 Holly LN
Glen Mills, PA 19342-9620 - Phone
- (610) 892-3800
- Fax
- (484) 468-1412
- NPI assigned
- Oct 3, 2006
- Last updated
- Jan 27, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS005852L | PA | Primary |
Addresses
Primary practice location
1204 Holly LN
Glen Mills, PA 19342-9620
Mailing address
1204 Holly Lane
Glen Mills, PA 19342
Phone (610) 892-3800
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS005852L | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Psychological PC | Past | Accepting new patients | |
| Optum Behavioral Care of Connecticut, P.C. | Past | Accepting new patients | |
| Delaware County Professional Services, Inc | Past | Accepting new patients |
Interoperability endpoints
- dcp.robertpalladino@141748.advancedmd-direct.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba LifeStance
- Psychiatry Physician
- Media, PA
- NPI 1952485864
-
dba Springfield Behavioral of Pennsylvania
- Counseling Psychologist
- Philadelphia, PA
- NPI 1811778988
-
dba Associates of Springfield Psychological
- Mental Health Counselor
- Springfield, PA
- NPI 1295705317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233014400000",
"number": "1780778720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 HOLLY LANE",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "19342",
"telephone_number": "610-892-3800",
"fax_number": "484-468-1412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 HOLLY LN",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "193429620",
"telephone_number": "610-892-3800",
"fax_number": "484-468-1412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLADINO",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "M ED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2009-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS005852L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Mills, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.