Provider Demographics
NPI:1477521672
Name:CHAMBERS, ALYCIA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALYCIA
Middle Name:A
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4823
Mailing Address - Country:US
Mailing Address - Phone:814-238-1880
Mailing Address - Fax:814-867-2794
Practice Address - Street 1:229 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4823
Practice Address - Country:US
Practice Address - Phone:814-238-1880
Practice Address - Fax:814-867-2794
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 005006 L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001560056Medicaid
PA113755OtherVALUE OPTIONS AND TRICARE
PA01120501OtherCAPITAL BLUE CROSS
PA528387 CHMedicare ID - Type Unspecified