Healthcare Provider Details

I. General information

NPI: 1427384361
Provider Name (Legal Business Name): PHYSIS ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 EXTON CMNS
EXTON PA
19341-2446
US

IV. Provider business mailing address

675 EXTON CMNS
EXTON PA
19341-2446
US

V. Phone/Fax

Practice location:
  • Phone: 610-269-3037
  • Fax: 610-280-3373
Mailing address:
  • Phone: 610-269-3037
  • Fax: 610-280-3373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS0037347-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KAROL BREWER
Title or Position: OFFICE MANAGER
Credential:
Phone: 610-547-2914