Organization Active NPI

Fellow Travelers Psychological Services, LLC

  • Clinical Psychologist
  • Clarks Summit, PA
National Provider Identifier
1881329209
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
FELLOW TRAVELERS PSYCHOLOGICAL SERVICES, LLC
Practice address
203 Greenwood Ave
Clarks Summit, PA 18411-1405
Phone
(570) 218-2402
Fax
(570) 227-0934
NPI assigned
Jul 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Natasha Coy, PSY.D.NPI 1528506078
Title
Psychologist/Owner
Phone
(570) 218-2402

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

203 Greenwood Ave
Clarks Summit, PA 18411-1405

Mailing address

203 Greenwood Ave
Clarks Summit, PA 18411-1405
Phone (570) 218-2402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221227000659 PA Part B Supplier - Clinic/Group Practice 8729458203 Receives reassigned benefits from 1 practitioner
Practice locations: Clarks Summit, PA

National Provider Directory

National Provider Directory

Locations

203 Greenwood Ave
Clarks Summit, PA 18411
Phone (570) 218-2402

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1881329209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 GREENWOOD AVE",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111405",
            "telephone_number": "570-218-2402",
            "fax_number": "570-227-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 GREENWOOD AVE",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111405",
            "telephone_number": "570-218-2402",
            "fax_number": "570-227-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELLOW TRAVELERS PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "COY",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "570-218-2402",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.