Active NPI
Bruce Woodward, PHD
- Clinical Psychologist
- Wayne, PA
National Provider Identifier
1871693390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS003235L
- Practice address
- 175 Strafford Avenue
Suite 1
Wayne, PA 19087 - Phone
- (610) 688-1650
- NPI assigned
- Sep 24, 2006
- Last updated
- Jul 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS003235L | PA | |
| Clinical Psychologist | 103TC0700X | PS003235L | PA | Primary |
| Counseling Psychologist | 103TC1900X | PS003235L | PA |
Addresses
Primary practice location
175 Strafford Avenue
Suite 1
Wayne, PA 19087
Mailing address
PO Box 7175
Saint Davids, PA 19087-7175
Phone (610) 688-1650
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7443321 | Other | PA | AETNA |
| 273480000 | Other | PA | KEYSTONE |
| 2321316000 | Other | PA | IBC |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS003235L | PA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1871693390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7175",
"city": "SAINT DAVIDS",
"state": "PA",
"postal_code": "190877175",
"telephone_number": "610-688-1650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 STRAFFORD AVENUE",
"address_2": "SUITE 1",
"city": "WAYNE",
"state": "PA",
"postal_code": "19087",
"telephone_number": "610-688-1650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODWARD",
"first_name": "BRUCE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2023-07-14",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS003235L",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS003235L",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PA",
"license": "PS003235L",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7443321",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "273480000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC",
"identifier": "2321316000",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.