Provider Demographics
NPI:1912319328
Name:ARBOR GROVE PSYCHOLOGICAL SERVICES, LLC.
Entity Type:Organization
Organization Name:ARBOR GROVE PSYCHOLOGICAL SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-995-0140
Mailing Address - Street 1:118 S BELLEVUE AVE
Mailing Address - Street 2:2ND FL. REAR
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2862
Mailing Address - Country:US
Mailing Address - Phone:215-995-0140
Mailing Address - Fax:
Practice Address - Street 1:118 S BELLEVUE AVE
Practice Address - Street 2:2ND FL. REAR
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2862
Practice Address - Country:US
Practice Address - Phone:215-995-0140
Practice Address - Fax:215-947-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016830103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty