Provider Demographics
NPI:1437113073
Name:CELEBRE, JEFFREY E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:E
Last Name:CELEBRE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 GOLFVIEW RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6409
Mailing Address - Country:US
Mailing Address - Phone:610-565-1445
Mailing Address - Fax:610-565-1660
Practice Address - Street 1:10 S PLUM ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3309
Practice Address - Country:US
Practice Address - Phone:610-565-1445
Practice Address - Fax:610-565-1660
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002451L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA117491OtherVALUE OPTIONS
PAQ86633OtherAMERIHEALTH
PA0033326000OtherPERSONAL CHOICE PIN #
PA4271274OtherAETNA HEALTH CARE
IL173547OtherCOMPSYCH
PA030206OtherHIGHMARK BLUE SHIELD
PA030206Medicare PIN