Active NPI
Lawrence George Mintzer, PH.D.
- Clinical Psychologist
- Yardley, PA
National Provider Identifier
1962530212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS004076L
- Practice address
- 608 Floral Vale Blvd
Yardley, PA 19067-5528 - Phone
- (215) 860-8413
- Fax
- (215) 860-8433
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS004076L | PA | Primary |
| Clinical Psychologist | 103TC0700X | 35SI00226700 | NJ |
Addresses
Primary practice location
608 Floral Vale Blvd
Yardley, PA 19067-5528
Mailing address
608 Floral Vale Blvd
Yardley, PA 19067-5528
Phone (215) 860-8413
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00226700 | NJ | MD | Clinical Psychologist |
| PS004076L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962530212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 FLORAL VALE BLVD",
"city": "YARDLEY",
"state": "PA",
"postal_code": "190675528",
"telephone_number": "215-860-8413",
"fax_number": "215-860-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 FLORAL VALE BLVD",
"city": "YARDLEY",
"state": "PA",
"postal_code": "190675528",
"telephone_number": "215-860-8413",
"fax_number": "215-860-8433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTZER",
"first_name": "LAWRENCE",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS004076L",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00226700",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yardley, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.