NPIMap

Organization Active NPI

Center for Integrative Psychotherapy PC

  • Clinical Psychologist
  • Allentown, PA
National Provider Identifier
1962461236
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS015605 Issued in PA
Legal business name
CENTER FOR INTEGRATIVE PSYCHOTHERAPY PC
Practice address
1251 S Cedar Crest Blvd
Suite 211D
Allentown, PA 18103-6205
Phone
(610) 432-5066
Fax
(610) 432-0973
NPI assigned
Mar 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Authorized official

Name
Mr. Jesus Alberto Salas, PSY.D.NPI 1801856505
Title
Director/Clinical Psychologist
Phone
(610) 432-5066

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: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PS015605 PA Primary

Addresses

Primary practice location

1251 S Cedar Crest Blvd
Suite 211D
Allentown, PA 18103-6205

Mailing address

1251 S Cedar Crest Blvd
Suite 211D
Allentown, PA 18103-6205
Phone (610) 432-5066

Other identifiers 2

IdentifierTypeStateIssuer
CE720536OtherPABLUE SHIELD INS. CO.
02506000OtherPACAPITAL BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060426000102 PA Part B Supplier - Clinic/Group Practice 2264442979 Receives reassigned benefits from 5 practitioners
Practice locations: Allentown, PA

National Provider Directory

National Provider Directory

Locations

1251 S Cedar Crest Blvd
Ste 211D
Allentown, PA 18103
Phone (610) 432-5066

1011 Brookside Rd
Ste 235
Allentown, PA 18106
Phone (610) 432-5066

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1962461236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD",
            "address_2": "SUITE 211D",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036205",
            "telephone_number": "610-432-5066",
            "fax_number": "610-432-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD",
            "address_2": "SUITE 211D",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036205",
            "telephone_number": "610-432-5066",
            "fax_number": "610-432-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATIVE PSYCHOTHERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "DIRECTOR/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "610-432-5066",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INS. CO.",
            "identifier": "CE720536",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02506000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.