Healthcare Provider Details
I. General information
NPI: 1689559627
Provider Name (Legal Business Name): THE ANXIETY TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 OXFORD VALLEY RD STE 1803A
YARDLEY PA
19067-7725
US
IV. Provider business mailing address
301 OXFORD VALLEY RD STE 1803A
YARDLEY PA
19067-7725
US
V. Phone/Fax
- Phone: 267-394-7805
- Fax:
- Phone: 267-394-7805
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1154859478 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | CLINICAL PSYCHOLOGIST |
VIII. Authorized Official
Name: DR.
MARK
SERGIO
FERREIRA
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 267-394-7805