Healthcare Provider Details

I. General information

NPI: 1063908499
Provider Name (Legal Business Name): PSYCHOLOGICAL SERVICES OF YORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 03/24/2022
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 EASTERN BLVD STE 204
YORK PA
17402-2903
US

IV. Provider business mailing address

2575 EASTERN BLVD STE 204
YORK PA
17402-2903
US

V. Phone/Fax

Practice location:
  • Phone: 717-870-7925
  • Fax: 717-467-4916
Mailing address:
  • Phone: 717-870-7925
  • Fax: 717-467-4916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS017453
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPS017453
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPS017453
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. AMY M. SWOPE
Title or Position: OWNER/LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 717-870-7925