Healthcare Provider Details

I. General information

NPI: 1780197368
Provider Name (Legal Business Name): ASHLEY MCCABE THOMAS-BOCK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 BROOKTREE RD STE 105
WEXFORD PA
15090-9299
US

IV. Provider business mailing address

6200 BROOKTREE RD STE 105
WEXFORD PA
15090-9299
US

V. Phone/Fax

Practice location:
  • Phone: 724-271-8503
  • Fax: 724-590-9766
Mailing address:
  • Phone: 724-271-8503
  • Fax: 724-590-9766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS020614
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS020614
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.07669
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS020614
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS020614
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: