Provider Demographics
NPI:1073657300
Name:RICHARD F. SMALL, PH.D., ABPP DBA SPRING PSYCHOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:RICHARD F. SMALL, PH.D., ABPP DBA SPRING PSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-678-3730
Mailing Address - Street 1:2909 WINDMILL RD
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1681
Mailing Address - Country:US
Mailing Address - Phone:610-678-3730
Mailing Address - Fax:610-678-7853
Practice Address - Street 1:2909 WINDMILL RD
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1681
Practice Address - Country:US
Practice Address - Phone:610-678-3730
Practice Address - Fax:610-678-7853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002912L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAR05347Medicare UPIN