Provider Demographics
NPI:1285008599
Name:YVONNE B REEDY PHD, PSYCHOLOGY AND COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:YVONNE B REEDY PHD, PSYCHOLOGY AND COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:REEDY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-931-7247
Mailing Address - Street 1:322-2 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-1454
Mailing Address - Country:US
Mailing Address - Phone:814-937-0668
Mailing Address - Fax:814-342-2532
Practice Address - Street 1:322-2 E PINE ST
Practice Address - Street 2:SUITE B
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-1454
Practice Address - Country:US
Practice Address - Phone:814-937-0668
Practice Address - Fax:814-342-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008217L103T00000X, 103TC1900X, 103TC2200X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022904950001Medicaid
PA1022904950001Medicaid