Provider Demographics
NPI:1083981104
Name:CENTER FOR INTEGRATED BEHAVIORAL HEALTH,LLC
Entity Type:Organization
Organization Name:CENTER FOR INTEGRATED BEHAVIORAL HEALTH,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLEGRINO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-715-0820
Mailing Address - Street 1:1 BETHLEHEM PLZ
Mailing Address - Street 2:SUITE 810
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5754
Mailing Address - Country:US
Mailing Address - Phone:610-865-4300
Mailing Address - Fax:
Practice Address - Street 1:1 BETHLEHEM PLZ
Practice Address - Street 2:SUITE 810
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5754
Practice Address - Country:US
Practice Address - Phone:610-865-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016995103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty