Provider Demographics
NPI:1710199781
Name:MCCOLLAUM, WILLIAM A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:MCCOLLAUM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 S MAIN ST
Mailing Address - Street 2:SUITE 2D PARK TERRACE
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4815
Mailing Address - Country:US
Mailing Address - Phone:215-345-5665
Mailing Address - Fax:215-345-5700
Practice Address - Street 1:275 S MAIN ST
Practice Address - Street 2:SUITE 2D PARK TERRACE
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4815
Practice Address - Country:US
Practice Address - Phone:215-345-5665
Practice Address - Fax:215-345-5700
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006008L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF99475OtherAMERIHEALTH ADMINISTRATOR
PA699475OtherPA.HIGHMARK
PA699475OtherPA.HIGHMARK