Healthcare Provider Details

I. General information

NPI: 1619326089
Provider Name (Legal Business Name): BUCKS COUNTY PSYCHOLOGICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S CLINTON ST STE 207
DOYLESTOWN PA
18901-4220
US

IV. Provider business mailing address

10 S CLINTON ST STE 207
DOYLESTOWN PA
18901-4220
US

V. Phone/Fax

Practice location:
  • Phone: 215-817-0190
  • Fax:
Mailing address:
  • Phone: 215-817-0190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAD M COREN
Title or Position: PSYCHOLOGIST
Credential: PSYD, CAADC
Phone: 215-817-0190