Individual provider Active NPI

Adrienne Ingram-Boslau, PSY.D.

  • Psychologist
  • Cranberry Township, PA
National Provider Identifier
1831374057
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS016364 Issued in PA
Practice address
3104 Unionville Rd Ste 175
Cranberry Township, PA 16066
Phone
(724) 776-3366
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS016364 PA Primary

Addresses

Primary practice location

3104 Unionville Rd Ste 175
Cranberry Township, PA 16066

Mailing address

3104 Unionville Rd Ste 175
Cranberry Township, PA 16066-3418
Phone (724) 776-3366

Other practice location 1

412 E Commons
Pittsburgh, PA 15212-5310
Phone (412) 442-8907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081117000777 PA Practitioner - Clinical Psychologist 3678633922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Suzanne R Lucot MD Psychiatric Services LLCGroup PAC ID 1254644057, 3 clinicians

Practice addresses (Care Compare)

20399 Route 19
Suite 203
Cranberry TWP, PA 16066

20399 Route 19
Suite 203
Cranberry TWP, PA 16066-6138
Phone (724) 776-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Suzanne R. Lucot MD Psychiatric Services LLC CurrentSince Mar 18, 2020 Accepting new patients

Locations

20399 Route 19
Ste 203
Cranberry Twp, PA 16066
Phone (724) 772-8000

3104 Unionville Rd
Ste 175
Cranberry Twp, PA 16066
Phone (724) 776-3366

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1831374057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 UNIONVILLE RD STE 175",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160663418",
            "telephone_number": "724-776-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 UNIONVILLE RD STE 175",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "16066",
            "telephone_number": "724-776-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 E Commons",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152125310",
            "country_code": "US",
            "telephone_number": "412-442-8907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGRAM-BOSLAU",
        "first_name": "ADRIENNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry Township, PA

Sources for this page

Verify at the official NPI Registry.