Provider Demographics
NPI:1740250083
Name:CROYLE PSYCHOLOGICAL ASSOCIATES
Entity type:Organization
Organization Name:CROYLE PSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROYLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-266-3196
Mailing Address - Street 1:1450 SCALP AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3374
Mailing Address - Country:US
Mailing Address - Phone:814-266-3196
Mailing Address - Fax:814-266-6296
Practice Address - Street 1:1450 SCALP AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3374
Practice Address - Country:US
Practice Address - Phone:814-266-3196
Practice Address - Fax:814-266-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-003270-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty