| Estadt Psychological Services, Llc | |
|
1930 S Broad St Philadelphia PA 19145-2328 | |
| (267) 304-3414 | |
| Not Available |
| Full Name | Estadt Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1930 S Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Gregory John Estadt (OWNER) |
| Authorized Official Contact | 2673043414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Estadt Psychological Services, Llc 2926 S 15th St Philadelphia PA 19145-4917 Ph: (267) 304-3414 | Estadt Psychological Services, Llc 1930 S Broad St Philadelphia PA 19145-2328 Ph: (267) 304-3414 |
| NPI Number | 1801288667 |
|---|---|
| Provider Enumeration Date | 03/03/2015 |
| Last Update Date | 03/03/2015 |
| Medicare PECOS PAC ID | 6800107640 |
|---|---|
| Medicare Enrollment ID | O20150619000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801288667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Erica E Burden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033227673 PECOS PAC ID: 3173622826 Enrollment ID: I20070807000308 |
| Provider Name | Gregory J Estadt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740445261 PECOS PAC ID: 4385812841 Enrollment ID: I20110727000727 |
| Provider Name | Janine E Oliver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679812689 PECOS PAC ID: 5799921433 Enrollment ID: I20130424000901 |
| Provider Name | Gerlinde Harb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447492715 PECOS PAC ID: 2264740786 Enrollment ID: I20151002002004 |
| Provider Name | Maureen A Townsend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982822870 PECOS PAC ID: 7315009164 Enrollment ID: I20151005000987 |
| Provider Name | Melissa Gonska |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912244062 PECOS PAC ID: 9436416633 Enrollment ID: I20171127000157 |
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