Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Prime Healthcare Services-Roxborough Providers LLC

Organization Psychologist · NPI 1649525627

Prime Healthcare Services-Roxborough Providers LLC is a Psychologist in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2012.

Licensed in
PA
In the registry since
2012
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5800 Ridge Ave
Philadelphia, PA 19128-1737
Phone: (215) 509-6826
Fax: (215) 487-4274
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X (PA)
Physician Assistant Taxonomy 363A00000X (PA)
Nurse Practitioner Taxonomy 363L00000X (PA)

Record details

NPI number1649525627
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Richards — Authorized Representative · (215) 509-6826
NPI enumeratedJuly 17, 2012
Last updated in NPPESApril 10, 2013
Mailing address5800 Ridge Ave, Philadelphia, PA 19128-1737

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