Provider Demographics
NPI:1619189081
Name:PIPER-SMYER, PATRICIA E (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:E
Last Name:PIPER-SMYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:ELLEN
Other - Last Name:PIPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:424 1/2 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1495
Mailing Address - Country:US
Mailing Address - Phone:570-524-1127
Mailing Address - Fax:
Practice Address - Street 1:424 1/2 MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1495
Practice Address - Country:US
Practice Address - Phone:570-524-1127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6823103TB0200X
PAPS002614L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6823OtherPSYCHOLOGY LICENSE
PAPS002614LOtherPA PSYCHOLOGY LICENSE
MAWW0484OtherBLUE CROSS BLUE SHIELD
MA6823OtherPSYCHOLOGY LICENSE