MR. BEAU CHARLES BRENDLEY (NPI# 1447537766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447537766 |
| Entity Type | Individual |
| Full Name | MR. BEAU CHARLES BRENDLEY |
| Credential | PSY D |
| Practice Address |
255 S 17th St Ste 1010 Philadelphia PA 19103-6210 |
| Mailing Address |
815 S 2nd St Philadelphia PA 19147-3415 |
| Practice Telephone | 6723195882 |
| Mailing Telephone | 2672319588 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2018-09-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
PC006129 | PA | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | PS018603 | PA | Behavioral Health & Social Service Providers |
| Street Address |
255 S 17TH ST STE 1010 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19103-6210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200061 | Ajabeyang Amin | Psychologist | 255 S 17th St Ste 1010, Philadelphia, PA 19103-6210 | 2020-09-22 |
| 1871114389 | Miriam Dp Geiger | Social Worker | 255 S 17th St Ste 1010, Philadelphia, PA 19103-6210 | 2020-05-06 |
| 1952957441 | Melissa Brennan | Counselor | 255 S 17th St Ste 1010, Philadelphia, PA 19103-6210 | 2019-08-12 |
| 1891260956 | Christine Wojnicz | Psychologist | 255 S 17th St Ste 1010, Philadelphia, PA 19103-6210 | 2018-10-04 |
| 1194212415 | Robin Cooper | Social Worker | 255 S 17th St Ste 1010, Philadelphia, PA 19103-6210 | 2018-04-23 |
| 1477923993 | Christopher Wilson | Marriage & Family Therapist | 255 S 17th St Ste 1010, Philadelphia, PA 19103-6210 | 2015-09-26 |
| 1851735047 | Afshan Ranjha | Psychiatry & Neurology | 255 S 17th St Ste 1010, Philadelphia, PA 19103 | 2013-04-18 |
| 1184998668 | Elizabeth Joan Recktenwald | Nurse Practitioner | 255 S 17th St Ste 1010, Philadelphia, PA 19103-6210 | 2012-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565431 | Allyson Caputa | Behavior Technician | 100 North 18th Street, Suite 300, Philadelphia, PA 19103 | 2020-10-13 |
| 1063062685 | Sarah Seeling | Social Worker | 255 South 17th Street Suite 1010, Suite 1500, Suite 23, Philadelphia, PA 19103 | 2019-09-16 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1932761863 | Barclay Prescription Pharmacy | Pharmacist | 1736 Spruce St, Phila, PA 19103 | 2019-07-01 |
| 1265910459 | Whitney Sue Fricke | Counselor | 2211 Locust St, Philadelphia, PA 19103 | 2018-07-31 |
| 1740784586 | Sara Elizabeth Macintyre | Speech-Language Pathologist | 1845 Walnut Street Suite 1540, Philadelphia, PA 19103 | 2018-03-19 |
| 1326578907 | Danielle D Bercovitch | Speech-Language Pathologist | 1930 S Broad, Philadelphia, PA 19103 | 2017-06-15 |
| 1598114449 | Brooke Elaine Mullen | Dietitian, Registered | 1708 Pine St Apt 1r, Philadelphia, PA 19103 | 2016-06-10 |
| 1972966026 | Alexandra Brady Jatzke | Dietitian, Registered | 1835 Market St Fl 2, Philadelphia, PA 19103 | 2016-04-05 |
| 1932574118 | David Clements Iv | Psychiatry & Neurology | 1845 Walnut St Ste 1540, Philadelphia, PA 19103 | 2015-12-14 |
| Find all providers in zip 19103 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578937 | Margaret Edwards | Psychologist | 110 S 20th St Ste 206, Philadelphia, PA 19103-4486 | 2020-11-03 |
| 1699374843 | Elizabeth Ann Johnson | Psychologist | 3640 Stanton St Apt 107, Philadelphia, PA 19129-1683 | 2020-10-20 |
| 1689272577 | Katherine Piselli | Psychologist | 3401 Market St Ofc 3216, Philadelphia, PA 19104-3318 | 2020-10-13 |
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1659980621 | Corinne Masur | Psychologist | 1601 Walnut St Ste 1408, Philadelphia, PA 19102-2909 | 2020-07-27 |
| 1730798067 | Amanda Marie Large | Psychologist | 1516 N 5th St Unit 401, Philadelphia, PA 19122-3679 | 2020-07-22 |
| 1295355543 | Jennifer Ann Engelhardt | Psychologist | 8201 Henry Ave Apt Q15, Philadelphia, PA 19128-2248 | 2020-04-16 |
| 1336778315 | Carly Mirit Gerbi | Psychologist | 2227 Delancey Pl, Philadelphia, PA 19103-6549 | 2020-04-02 |
| 1811530512 | Tower Drexel Academic Medical Group LLC | Psychologist | 1427 Vine St Fl 1, Philadelphia, PA 19102-1031 | 2019-10-25 |
| 1003459702 | Tower Drexel Academic Medical Group LLC | Psychologist | 4700 Wissahickon Ave Ste C102, Philadelphia, PA 19144-4248 | 2019-10-25 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.