NPIMap

Organization Active NPI

Premier Health Psychology, LLC

  • Clinical Psychologist
  • Harleysville, PA
National Provider Identifier
1902386261
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS017738 Issued in PA
Legal business name
PREMIER HEALTH PSYCHOLOGY, LLC
Practice address
173 Main St
Harleysville, PA 19438-2514
Phone
(267) 890-7233
NPI assigned
Aug 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Authorized official

Name
Dr. Laura E Simonelli, PH.D.NPI 1154587715
Title
Director & Licensed Psychologist
Phone
(267) 890-7233

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PS017738 PA Primary
Health PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0004X PS017738 PA

Addresses

Primary practice location

173 Main St
Harleysville, PA 19438-2514

Mailing address

522 Grayson LN
Harleysville, PA 19438
Phone (267) 890-7233

Other practice location 1

140 Clemens Rd Ste 104
Harleysville, PA 19438
Phone (267) 890-7233

Other identifiers 1

IdentifierTypeStateIssuer
1154587715MedicaidDE

National Provider Directory

National Provider Directory

Locations

173 Main St
Harleysville, PA 19438
Phone (215) 256-8889

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": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584576000000",
    "number": "1902386261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 GRAYSON LN",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "19438",
            "telephone_number": "267-890-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 MAIN ST",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194382514",
            "telephone_number": "267-890-7233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Clemens Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Harleysville",
            "state": "PA",
            "postal_code": "19438",
            "country_code": "US",
            "telephone_number": "267-890-7233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER HEALTH PSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A",
        "authorized_official_last_name": "SIMONELLI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR & LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "267-890-7233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017738",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": "PA",
            "license": "PS017738",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154587715",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harleysville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.