Individual provider Active NPI

John T Spychalski, M.ED.

  • Clinical Psychologist
  • Lancaster, PA
National Provider Identifier
1871679548
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS003849L Issued in PA
Practice address
790 New Holland Ave
Lancaster, PA 17602-2137
Phone
(717) 390-0353
Fax
(717) 390-1812
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS003849L PA Primary

Addresses

Primary practice location

790 New Holland Ave
Lancaster, PA 17602-2137

Mailing address

PO Box 597
Suite 805
Mountville, PA 17554-0597
Phone (570) 323-6944

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
I20120302000206 PA Practitioner - Clinical Psychologist 1759540206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Services Group IncGroup PAC ID 1052201571, 32 clinicians

Practice addresses (Care Compare)

1000 Commerce Park Dr
Suite 110
Williamsport, PA 17701-5475
Phone (570) 323-6944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Community Services Group, Inc. CurrentSince Nov 22, 2011 Accepting new patients

Locations

790 New Holland Ave
Lancaster, PA 17602
Phone (717) 293-5104

1902 Olde Homestead Ln
Lancaster, PA 17601
Phone (717) 285-7121

1000 Commerce Park Dr
Ste 110
Williamsport, PA 17701
Phone (570) 323-6944

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1871679548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "address_2": "SUITE 805",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175540597",
            "telephone_number": "570-323-6944",
            "fax_number": "570-323-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 NEW HOLLAND AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022137",
            "telephone_number": "717-390-0353",
            "fax_number": "717-390-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPYCHALSKI",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS003849L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.