Provider Demographics
NPI:1992779193
Name:MCAULEY, PATRICIA LYNNE OLSEN (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA LYNNE
Middle Name:OLSEN
Last Name:MCAULEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LYNNE
Other - Middle Name:OLSEN
Other - Last Name:MCAULEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:309 E DARK HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947-9375
Mailing Address - Country:US
Mailing Address - Phone:215-766-1356
Mailing Address - Fax:215-766-1356
Practice Address - Street 1:182 W COURT ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4106
Practice Address - Country:US
Practice Address - Phone:215-766-1356
Practice Address - Fax:215-766-1356
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV61601Medicare PIN