NPIMap

Organization Active NPI

Anxiety & Agoraphobia Treatment Center, PC

  • Clinical Psychologist
  • Bala Cynwyd, PA
National Provider Identifier
1912015603
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ANXIETY & AGORAPHOBIA TREATMENT CENTER, PC
Practice address
112 Bala Ave
Bala Cynwyd, PA 19004-3025
Phone
(610) 667-6490
Fax
(610) 667-1744
NPI assigned
Aug 25, 2006
Last updated
Feb 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Ms. Barbara J Foster-Daley
Title
Administrator
Phone
(610) 667-6490

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

112 Bala Ave
Bala Cynwyd, PA 19004-3025

Mailing address

112 Bala Ave
Bala Cynwyd, PA 19004-3025
Phone (610) 667-6490

Other identifiers 1

IdentifierTypeStateIssuer
027365000OtherMAGELLAN BEHAVIORAL HEALT

Other names 1

  • Agoraphobia & Anxiety Treatment Center Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1912015603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BALA AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043025",
            "telephone_number": "610-667-6490",
            "fax_number": "610-667-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BALA AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043025",
            "telephone_number": "610-667-6490",
            "fax_number": "610-667-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANXIETY & AGORAPHOBIA TREATMENT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "FOSTER-DALEY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "610-667-6490",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "027365000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agoraphobia & Anxiety Treatment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.