Shirley Mackley, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS 017048 Issued in PA

Practice address

194 New Bridgeville Rd
Wrightsville, PA 17368-9052

Phone

(717) 880-8517

NPI assigned

Feb 17, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Philadelphia College of Osteopathic Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vital Healthcare Solutions 107 clinicians

Silver Willow Wellness PC 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Silver Willow Wellness PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Reading, PA
  • NPI 1659164697

  PA

  Medicare reassignment Care Compare group NPD
• Vital Healthcare Solutions

  • Psychiatry Physician
  • Sinking Springs, PA
  • NPI 1659736957

  PA

  Medicare reassignment Care Compare group NPD
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  PA, Psychologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1992002406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 NEW BRIDGEVILLE RD",
            "city": "WRIGHTSVILLE",
            "state": "PA",
            "postal_code": "173689052",
            "telephone_number": "717-880-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 NEW BRIDGEVILLE RD",
            "city": "WRIGHTSVILLE",
            "state": "PA",
            "postal_code": "173689052",
            "telephone_number": "717-880-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLEY",
        "first_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC001000",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS 017048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Diane Hoke, ATC
• John M Jensen
• Lancaster General Health - Columbia Center
• Susana Larvie, CRNP
• Liu #12 School Based Partial Hospitalization Program
• Nzingha Martin
• Robert C Matylewicz Jr., D.O.
• Alyssa Noll
• PB Outpatient Services Pennsylvania, LLC
• Cara Petersen

• All providers in Wrightsville, PA
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.