Provider Demographics
NPI:1063908499
Name:PSYCHOLOGICAL SERVICES OF YORK, LLC
Entity type:Organization
Organization Name:PSYCHOLOGICAL SERVICES OF YORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SWOPE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-870-7925
Mailing Address - Street 1:2575 EASTERN BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2903
Mailing Address - Country:US
Mailing Address - Phone:717-870-7925
Mailing Address - Fax:717-467-4916
Practice Address - Street 1:2575 EASTERN BLVD STE 204
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2903
Practice Address - Country:US
Practice Address - Phone:717-870-7925
Practice Address - Fax:717-467-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017453103TM1800X, 103TS0200X, 103T00000X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1035114560001Medicaid
PA1035728360001Medicaid