DEVONDRIAN WOMACK (NPI# 1487267126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487267126 |
Entity Type | Individual |
Full Name | DEVONDRIAN WOMACK |
Credential | CPS |
Practice Address |
1041 W Bridge St Ste B5 Phoenixville PA 19460-4342 |
Practice Telephone | 6104159301 |
Practice Fax Number | 6104159301 |
Mailing Telephone | 6104159301 |
Mailing Fax Number | 6104159301 |
Enumeration Date | 2020-08-24 |
Last Update Date | 2020-08-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
Street Address |
1041 W BRIDGE ST STE B5 |
City | PHOENIXVILLE |
State | PA |
Zip Code | 19460-4342 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639732670 | Megan Elizabeth Reppert | Counselor | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2019-04-16 |
1245837939 | Madeline Hoot | Case Manager/Care Coordinator | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-10-06 |
1235744756 | Tianna Wagner | Counselor | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-09-11 |
1124638648 | Erin Frame | Case Manager/Care Coordinator | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-08-10 |
1205446143 | Carlee Conrad | Social Worker | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-08-05 |
1801405469 | Sadiyah Noel | Peer Specialist | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-07-29 |
1033727102 | Bailey Bain | Case Manager/Care Coordinator | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-07-15 |
1497389266 | Shaila Thomas | Case Manager/Care Coordinator | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-03-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215537030 | Dominique Butz | Counselor | 100 Yearsley Mill Road, Lima, PA 19460 | 2020-10-30 |
1801360573 | Pennsylvania Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 710 Wheatland St Ste 1, Phoenixville, PA 19460 | 2019-01-16 |
1518482702 | Megan Blair Webb | Massage Therapist | 215 Pine Drive, Phoenixville, PA 19460 | 2017-08-08 |
1053867697 | Steven Mehl | Psychologist | 865 Woodlawn Ave., Phoenixville, PA 19460 | 2016-09-01 |
1023564762 | Elizabeth Tarka | Internal Medicine | 111 Waverly Circle, Phoenixville, PA 19460 | 2016-09-01 |
1477901874 | Valley Forge Family Dentistry | Clinic/Center | 1288 Valley Forge Rd #70, Valley Forge, PA 19460 | 2016-05-26 |
1184088429 | Gisselle Vargas | Massage Therapist | 220 Third Ave, Phoenixville, PA 19460 | 2016-04-13 |
1992179022 | Monir Morgan | Counselor | 1041 West Bridge Street, Phoenixville, PA 19460 | 2015-12-01 |
1437531548 | Hiteshkumar K Nada | Dentist | 247 Schuylkill Road Phoenixville, Phoenixville, PA 19460 | 2015-06-25 |
1871995464 | Smart Serve Medical | Durable Medical Equipment & Medical Supplies | 69 Greenbriar Drive, Phoenixville, PA 19460 | 2014-09-25 |
Find all providers in zip 19460 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023661113 | Gertrude Cunningham | Peer Specialist | 1041 W Bridge St Ste 420, Phoenixville, PA 19460-4342 | 2019-07-18 |
1801405469 | Sadiyah Noel | Peer Specialist | 1041 W Bridge St Ste B5, Phoenixville, PA 19460-4342 | 2020-07-29 |
1891349395 | Lauren Gervasio | Peer Specialist | 1041 W Bridge St, Phoenixville, PA 19460-4342 | 2019-08-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053911313 | Become Empowered | Peer Specialist | 529 Wyoming Ave, Scranton, PA 18509-3009 | 2020-10-27 |
1316545379 | Antoine Johnson | Peer Specialist | 846 N 63rd St, Philadelphia, PA 19151-3443 | 2020-10-13 |
1336766765 | Marvin Mccloe | Peer Specialist | 1020 W Lackawanna Ave Ste 380, Scranton, PA 18504-2052 | 2020-07-01 |
1679198535 | Pamela Macon | Peer Specialist | 221 Ridge Ave, New Kensington, PA 15068-5432 | 2020-06-16 |
1750902490 | Jamie Paige Eisner | Peer Specialist | 3934 Foster St, Apartment 332, Pittsburgh, PA 15201 | 2020-05-05 |
1134755861 | Teri Julia Joscak | Peer Specialist | 515 Arlington Ave, North Versailles, PA 15137-1914 | 2020-03-13 |
1003449307 | Melissa Miles | Peer Specialist | 101 Abbey Dr, Linfield, PA 19468-3310 | 2020-02-15 |
1326685256 | The Warm House of Greater Pittsburgh | Peer Specialist | 249 N Craig St, Pittsburgh, PA 15213-1577 | 2019-12-10 |
1477190981 | Barry Gilliam | Peer Specialist | 220 Sycamore Ridge Dr, Springdale, PA 15144-1054 | 2019-12-03 |
1336783943 | Jessica Elease Elam | Peer Specialist | 5450 Wissahickon Ave Apt B1139, Philadelphia, PA 19144-5285 | 2019-11-06 |
Find all providers with the same taxonomy |
City | PHOENIXVILLE |
Zip Code | 19460 |
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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.