Provider Demographics
NPI:1427124924
Name:AMES, GARY (MA)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:AMES
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ROCK HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2132
Mailing Address - Country:US
Mailing Address - Phone:610-668-3223
Mailing Address - Fax:610-668-0213
Practice Address - Street 1:28 ROCK HILL RD
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2132
Practice Address - Country:US
Practice Address - Phone:610-668-3223
Practice Address - Fax:610-668-0213
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005947L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist