Provider Demographics
NPI:1518028562
Name:CATHERINE SELTH SPAYD PHD PC
Entity Type:Organization
Organization Name:CATHERINE SELTH SPAYD PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SPAYD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-693-0617
Mailing Address - Street 1:841 THIRD AVENUE
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-1424
Mailing Address - Country:US
Mailing Address - Phone:814-693-0617
Mailing Address - Fax:814-693-0617
Practice Address - Street 1:841 THIRD AVENUE
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-1424
Practice Address - Country:US
Practice Address - Phone:814-693-0617
Practice Address - Fax:814-693-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006177L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01704924Medicaid
PA211350OtherUPMC
PA715807OtherHIGHMARK BCBS
PASP715807Medicare ID - Type Unspecified