Healthcare Provider Details

I. General information

NPI: 1083030746
Provider Name (Legal Business Name): HEATHER C PINTO PSYD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 NEWTOWN YARDLEY RD STE 422
NEWTOWN PA
18940-4503
US

IV. Provider business mailing address

790 NEWTOWN YARDLEY RD STE 422
NEWTOWN PA
18940-4503
US

V. Phone/Fax

Practice location:
  • Phone: 215-579-2180
  • Fax: 215-579-2060
Mailing address:
  • Phone: 215-579-2180
  • Fax: 215-579-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS016656
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER C PINTO
Title or Position: PRESIDENT
Credential: PSYD
Phone: 215-579-2180