Provider Demographics
NPI:1518070515
Name:CHILD AND ADOLESCENT CLINICAL ASSOCIATES, INC.
Entity type:Organization
Organization Name:CHILD AND ADOLESCENT CLINICAL ASSOCIATES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ANDOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:724-776-0350
Mailing Address - Street 1:501 SMITH DR STE 6
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-4133
Mailing Address - Country:US
Mailing Address - Phone:724-776-0350
Mailing Address - Fax:724-776-5244
Practice Address - Street 1:501 SMITH DR STE 6
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-4133
Practice Address - Country:US
Practice Address - Phone:724-776-0350
Practice Address - Fax:724-776-5244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004396-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty