Provider Demographics
NPI:1871829119
Name:ALYSON NERENBERG PSYCHOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:ALYSON NERENBERG PSYCHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:NERENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-331-7303
Mailing Address - Street 1:510 MONTICELLO RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462
Mailing Address - Country:US
Mailing Address - Phone:610-331-7303
Mailing Address - Fax:215-242-5115
Practice Address - Street 1:8627 GERMANTOWN AVE.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118
Practice Address - Country:US
Practice Address - Phone:610-331-7303
Practice Address - Fax:215-242-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008867L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2138784OtherHIGHTMARK BLUE SHIELD
PA192585Medicare PIN