| Suburban Psychological Services, Inc. | |
|
210 Tower Rd Villanova PA 19085-1214 | |
| (610) 520-0443 | |
| (315) 285-1598 |
| Full Name | Suburban Psychological Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 210 Tower Rd, Villanova, Pennsylvania |
| Authorized Official Name and Position | Lee A. Bowers (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6105200443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Psychological Services, Inc. Po Box 7055 Saint Davids PA 19087-7055 Ph: (610) 520-0443 | Suburban Psychological Services, Inc. 210 Tower Rd Villanova PA 19085-1214 Ph: (610) 520-0443 |
| NPI Number | 1699963900 |
|---|---|
| Provider Enumeration Date | 10/11/2007 |
| Last Update Date | 10/11/2007 |
| Medicare PECOS PAC ID | 3072600808 |
|---|---|
| Medicare Enrollment ID | O20071026000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699963900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | PS-006234-L (Pennsylvania) | Primary |
| Provider Name | Lee Ailes Bowers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184621930 PECOS PAC ID: 5597851626 Enrollment ID: I20071019000381 |
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