Healthcare Provider Details

I. General information

NPI: 1427276468
Provider Name (Legal Business Name): MICHAEL CHARLES DYSON PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20134 VALLEY FORGE CIR
KING OF PRUSSIA PA
19406-1112
US

IV. Provider business mailing address

20134 VALLEY FORGE CIR
KING OF PRUSSIA PA
19406-1112
US

V. Phone/Fax

Practice location:
  • Phone: 267-751-3122
  • Fax: 267-552-1002
Mailing address:
  • Phone: 610-878-9330
  • Fax: 267-552-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: