Active NPI
Elite Educational and Therapeutic Support Services
- School Psychologist
- Rowland Heights, CA
National Provider Identifier
1891384038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Legal business name
- ELITE EDUCATIONAL AND THERAPEUTIC SUPPORT SERVICES
- Practice address
- 17946 Contador Dr
Rowland Heights, CA 91748-4328 - Phone
- (570) 466-5870
- NPI assigned
- Jan 12, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Richard A Shillabeer, PSY.D.
- Title
- Ceo
- Phone
- (570) 466-5870
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) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
17946 Contador Dr
Rowland Heights, CA 91748-4328
Mailing address
155 Columbia St
Duryea, PA 18642-1403
Phone (570) 466-5870
Other practice location 1
155 Columbia St
Duryea, PA 18642-1403
Phone (570) 466-5870
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LEP3615 | Other | CA | EDUCATIONAL PSYCHOLOGY |
National Provider Directory
National Provider DirectoryPractitioners & 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": "1610409600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1610409600000",
"number": "1891384038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 COLUMBIA ST",
"city": "DURYEA",
"state": "PA",
"postal_code": "186421403",
"telephone_number": "570-466-5870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17946 CONTADOR DR",
"city": "ROWLAND HEIGHTS",
"state": "CA",
"postal_code": "917484328",
"telephone_number": "570-466-5870"
}
],
"practiceLocations": [
{
"address_1": "155 Columbia St",
"address_purpose": "LOCATION",
"city": "Duryea",
"state": "PA",
"postal_code": "186421403",
"country_code": "US",
"telephone_number": "570-466-5870",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ELITE EDUCATIONAL AND THERAPEUTIC SUPPORT SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-12",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A",
"authorized_official_last_name": "SHILLABEER",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "570-466-5870",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSY.D."
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATIONAL PSYCHOLOGY",
"identifier": "LEP3615",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rowland Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.