Healthcare Provider Details

I. General information

NPI: 1285008599
Provider Name (Legal Business Name): YVONNE B REEDY PHD, PSYCHOLOGY AND COUNSELING ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322-2 E PINE ST SUITE B
PHILIPSBURG PA
16866-1454
US

IV. Provider business mailing address

322-2 E PINE ST
PHILIPSBURG PA
16866-1454
US

V. Phone/Fax

Practice location:
  • Phone: 814-937-0668
  • Fax: 814-342-2532
Mailing address:
  • Phone: 814-937-0668
  • Fax: 814-342-2532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS008217L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS008217L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS008217L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPS008217L
License Number StatePA

VIII. Authorized Official

Name: YVONNE B REEDY
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 814-931-7247