WEST PHILA COMMUNITY MENTAL HEALTH CONSORTIUM, INC. (NPI# 1194757989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194757989 |
| Entity Type | Organization |
| Organization Name | WEST PHILA COMMUNITY MENTAL HEALTH CONSORTIUM, INC. |
| Other Organization Name | THE CONSORTIUM, INC. |
| Practice Address |
451 S University Ave Philadelphia PA 19104-4544 |
| Mailing Address |
3801 Market St Ste 201 Philadelphia PA 19104-3153 |
| Practice Telephone | 2155968100 |
| Practice Fax Number | 2153824405 |
| Mailing Telephone | 2155968100 |
| Mailing Fax Number | 2153824405 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-08-30 |
| Authorized Official Name | MR. JOHN F WHITE JR. (PRESIDENT/CEO) |
| Authorized Official Telephone | 2155968100 |
| Authorized Official Credential | N/A |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
PA | Behavioral Health & Social Service Providers | |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
PA | Behavioral Health & Social Service Providers | |
| Y | 101Y00000X | Counselor | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 100715523 0001 | 05 |
| Other Name | Type Code |
|---|---|
| THE CONSORTIUM, INC. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841319332 | West Phila Community Mental Health Consortium, Inc. | Clinic/Center | 5501 Chestnut St, Philadelphia, PA 19139-3205 | 2007-03-28 |
| Street Address |
451 S UNIVERSITY AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548449085 | West Philadelphia Community Mental Health Consortium Inc. | Community/Behavioral Health | 451 S University Ave, Philadelphia, PA 19104-4544 | 2007-11-01 |
| 1134249535 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 451 S University Ave, Philadelphia, PA 19104-4544 | 2007-03-30 |
| 1245350081 | West Philadelphia Community Mh Consortium Inc. | Community/Behavioral Health | 451 S University Ave, Philadelphia, PA 19104-4544 | 2007-03-29 |
| 1669599973 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 451 S University Ave, Philadelphia, PA 19104-4544 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737412 | Tara Jenkins | Counselor | 6701 Woolston Ave, Philadelphia, PA 19138-2628 | 2020-10-11 |
| 1124635339 | Elizabeth Hoffman Sporer | Counselor | 1318 Marlborough St, Philadelphia, PA 19125-3215 | 2020-09-30 |
| 1437764933 | Elizabeth Richburg | Counselor | 5709 W Jefferson St, Philadelphia, PA 19131-3417 | 2020-09-11 |
| 1144833153 | Taylor Daly | Counselor | 7002 Cresheim Rd, Philadelphia, PA 19119-2535 | 2020-08-28 |
| 1871117093 | Arnold Tim Massaquoi | Counselor | 461 Aurania St, Philadelphia, PA 19128-4010 | 2020-06-03 |
| 1891315453 | Alice D Gresham | Counselor | 2025 Conlyn St, Philadelphia, PA 19138-2925 | 2020-04-23 |
| 1518587864 | Wesley G Harris IIi | Counselor | 1621 N 54th St, Philadelphia, PA 19131-4002 | 2020-04-16 |
| 1497383954 | R Denise Coles | Counselor | 7320 Sommers Rd, Philadelphia, PA 19138-1330 | 2020-03-31 |
| 1023645058 | Sicklecelldeiseasassociationofamericaphiladelphia/delawarevalleychapte | Counselor | 5300 Wynnefield Ave Fl 2, Philadelphia, PA 19131-2318 | 2020-03-27 |
| 1245873736 | Antonia Cianfrani | Counselor | 1901 S 9th St Ste 520, Philadelphia, PA 19148-2391 | 2019-10-28 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on WEST PHILA COMMUNITY MENTAL HEALTH CONSORTIUM, INC..
| 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.