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Contact Information

LIFEPSYCH CORP
102 BROWNING LN
BLDG C, SUITE 5
CHERRY HILL, NJ08003-3195
 Phone: 856-857-0881
 Fax: 610-361-9078
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Forensic

103TF0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIFEPSYCH CORP

NPI Number 1720188014
LBN Legal business name LIFEPSYCH CORP
Authorized official LELAND MOSBY - (PRESIDENT-CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2006
Last updated 07/14/2023 - About 3 years ago
Identifiers
NJ License # SI03313
NJ Medicaid 84554302
NJ Other 3546773 AETNA
NJ Other 2319112000 AMERIA HEALTH
NJ Other 538606000 MAGELLAN
NJ Other 001664744 PERSONAL CHOICE
PA Other 2319112000 PA BC
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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