Provider Demographics
NPI:1669405726
Name:ALPAUGH, NELSON S JR (PHD)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:S
Last Name:ALPAUGH
Suffix:JR
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 1:200 SHELL ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4731
Mailing Address - Country:US
Mailing Address - Phone:717-657-3867
Mailing Address - Fax:
Practice Address - Street 1:200 SHELL ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4731
Practice Address - Country:US
Practice Address - Phone:717-657-3867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003243L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018127160001Medicaid
PAAL086427Medicare ID - Type Unspecified