MEDICARE: PEDIATRIC PSYCHOLOGY CENTER OF CHESTER COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1629669627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC PSYCHOLOGY CENTER OF CHESTER COUNTY

Provider Business Mailing Address
First Line	:	341 E LANCASTER AVE STE 2
Second Line	:
City	:	DOWNINGTOWN
State	:	PA
Zip	:	19335-2974
Country	:	US
Telephone Number	:	610-723-8176
Fax Number	:

Provider Business Practice Location Address
First Line	:	341 E LANCASTER AVE STE 2
Second Line	:
City	:	DOWNINGTOWN
State	:	PA
Zip	:	19335-2974
Country	:	US
Telephone Number	:	610-723-8176
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICAL PSYCHOLOGIST
Name	:	ERIN ADAMITIS
Credential	:	PSYD
Telephone Number	:	610-223-9356

Provider Enumeration Date	:	02/01/2021
Last Update Date	:	02/01/2021

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