MEDICARE: ASF PSYCHOLOGICAL AND THERPEUTIC SERVICES, LLC

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	103TC0700X	Clinical Psychologist	PS016287	PA

General Provider Information

NPI Number	:	1720362908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASF PSYCHOLOGICAL AND THERPEUTIC SERVICES, LLC

Provider Business Mailing Address
First Line	:	331 W STATE ST
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-2615
Country	:	US
Telephone Number	:	610-574-1262
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 E FRONT ST
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-2911
Country	:	US
Telephone Number	:	610-574-1262
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	AMANDA FUHRMAN
Credential	:	PSYD
Telephone Number	:	610-574-1262

Provider Enumeration Date	:	10/05/2011
Last Update Date	:	11/03/2025

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