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General NPI Number Information
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NPI Number | 1619059367
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Entity Type | Individual
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Provider Name | STACEY G WARREN PHD
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 670 WOODBOURNE RD SUITE 302
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City | LANGHORNE
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State | PA
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Zip | 19047
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Country | US
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Telephone | 215-750-5525
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Fax | 215-750-5538
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Provider Business Mailing Address
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Address Line | PO BOX 215
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City | BUCKINGHAM
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State | PA
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Zip | 18912-0215
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Country | US
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Telephone | 215-750-5525
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Fax | 215-750-5538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS015003
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS015003
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License Number State | PA
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