Provider Demographics
NPI:1316528870
Name:NORTHERN BERKS PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:NORTHERN BERKS PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KELBISH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-914-8256
Mailing Address - Street 1:92 NOBLE ST APT B
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-1714
Mailing Address - Country:US
Mailing Address - Phone:610-914-8256
Mailing Address - Fax:717-584-5247
Practice Address - Street 1:92 NOBLE ST APT B
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-1714
Practice Address - Country:US
Practice Address - Phone:610-914-8256
Practice Address - Fax:717-584-5247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty