NPIMap

Organization Active NPI

Advanced Behavioral Health

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1952570558
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
ADVANCED BEHAVIORAL HEALTH
Practice address
2109 Red Lion Rd
Philadelphia, PA 19115-1711
Phone
(732) 901-0035
Fax
(732) 905-9891
NPI assigned
Feb 27, 2008
Last updated
Jun 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Issac S Gelley
Title
Owner
Phone
(732) 901-0035

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Psychologist 103T00000X Primary
Social Worker 104100000X

Addresses

Primary practice location

2109 Red Lion Rd
Philadelphia, PA 19115-1711

Mailing address

681 River Ave Ste 2E
Lakewood, NJ 08701-5229
Phone (732) 901-0035

National Provider Directory

National Provider Directory

Locations

128 Chestnut St
Philadelphia, PA 19106
Phone (267) 225-2820

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1952570558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 RIVER AVE STE 2E",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015229",
            "telephone_number": "732-901-0035",
            "fax_number": "732-905-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 RED LION RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151711",
            "telephone_number": "732-901-0035",
            "fax_number": "732-905-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "GELLEY",
        "authorized_official_first_name": "ISSAC",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-901-0035"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.