Consulting & Therapeutic Modalities Inc

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PS2609L Issued in PA

Legal business name

CONSULTING & THERAPEUTIC MODALITIES INC

Practice address

555 City Ave
Ste 210
Bala Cynwyd, PA 19004-1141

Phone

(610) 660-8338

Fax

(610) 660-8339

NPI assigned

Oct 18, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roman Joseph Pastushak, PHD

Title

Pres Sole Owner

Phone

(215) 364-1799

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Roman J Pastushak Other name

Locations

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790774248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 CYNTHIA DR",
            "city": "RICHBORO",
            "state": "PA",
            "postal_code": "189541331",
            "telephone_number": "215-364-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CITY AVE",
            "address_2": "STE 210",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041141",
            "telephone_number": "610-660-8338",
            "fax_number": "610-660-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTING & THERAPEUTIC MODALITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PASTUSHAK",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRES SOLE OWNER",
        "authorized_official_telephone_number": "215-364-1799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS2609L",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "DE",
            "license": "B10000525",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7402114",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roman J Pastushak",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Counseling Psychologist in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Counseling Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.