Provider Demographics
NPI:1336100387
Name:VALLEY PSYCHOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:VALLEY PSYCHOLOGICAL ASSOCIATES
Other - Org Name:VALLEY NEUROPSYCHOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KINS
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-433-3360
Mailing Address - Street 1:1045 S CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5443
Mailing Address - Country:US
Mailing Address - Phone:610-433-3360
Mailing Address - Fax:610-432-3110
Practice Address - Street 1:1045 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-5443
Practice Address - Country:US
Practice Address - Phone:610-433-3360
Practice Address - Fax:610-432-3110
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY PSYCHOLOGICAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-29
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004698L103G00000X, 103TC0700X
PAPS007168L103T00000X
PAPS002825L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02303300OtherCAPITAL BC
PA128420000OtherMAGELLAN HEALTH SERVICES
PA1336100387OtherVALLEY PSYCHOLOGICAL ASSO
PA484903OtherHIGHMARK - JAMES K. MARGO
PA484906OtherHIGHMARK - MEREDITH R. MA
PA235642OtherVALUE OPTIONS
PA790963391OtherDUNS #
PA=========OtherTAX ID NO.
PA484906Medicare PIN
PA484903OtherHIGHMARK - JAMES K. MARGO
PA790963391OtherDUNS #