PHILADELPHIA MENTAL HEALTH CLINIC (NPI# 1760644744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760644744 |
| Entity Type | Organization |
| Organization Name | PHILADELPHIA MENTAL HEALTH CLINIC |
| Other Organization Name | PHILADELPHIA MENTAL HEALTH CENTER |
| Practice Address |
1235 Pine St Philadelphia PA 19107-5945 |
| Practice Telephone | 2157359379 |
| Practice Fax Number | 2157358806 |
| Mailing Telephone | 2157359379 |
| Mailing Fax Number | 2157358806 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | MR. ALLEN ANDERSON (DIRECTOR BILLING/PC SYSTEMS) |
| Authorized Official Telephone | 2157355674 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 123880 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007279540005 | 05 | |
| PA | MAGELLAN | 265050000 | 01 |
| PA | BC | 000138598 | 01 |
| Other Name | Type Code |
|---|---|
| Philadelphia Mental Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780746917 | Philadelphia Mental Health Clinic | Clinic/Center | 1235 Pine Street, Philadelphia, PA 19107-5945 | 2006-12-14 |
| 1184745572 | Philadelphia Mental Health Clinic | Clinic/Center | 1235 Pine St, Philadelphia, PA 19107-5945 | 2007-04-03 |
| Street Address |
1235 PINE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-5945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306987706 | Ademola Maroof Owodunni | Social Worker | 1235 Pine St, Philadelphia, PA 19107-5945 | 2007-02-09 |
| 1710409313 | Austin Saiz | Counselor | 1235 Pine St, Philadelphia, PA 19107-5945 | 2017-07-14 |
| 1346790789 | Luceann M Hitchman | Social Worker | 1235 Pine St, Philadelphia, PA 19107-5945 | 2016-10-10 |
| 1205293024 | Stevie French | Counselor | 1235 Pine St, Philadelphia, PA 19107-5945 | 2016-01-25 |
| 1134518269 | Raymond Thomas Evans Jr. | Counselor | 1235 Pine St, Philadelphia, PA 19107-5945 | 2015-01-13 |
| 1720476898 | Nadia Darbouze | Social Worker | 1235 Pine St, Philadelphia, PA 19107-5945 | 2014-12-24 |
| 1366841298 | Jessica Henninger | Counselor | 1235 Pine St, Philadelphia, PA 19107-5945 | 2014-08-15 |
| 1487942355 | Peter Joseph Tappon | Social Worker | 1235 Pine St, Philadelphia, PA 19107-5945 | 2011-07-13 |
| 1972801686 | Ifeanyi Azubuike | Social Worker | 1235 Pine St, Philadelphia, PA 19107-5945 | 2011-03-03 |
| 1720386626 | Anthony Russo | Behavioral Analyst | 1235 Pine St, Philadelphia, PA 19107-5945 | 2011-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820754 | The Nava Center, Inc. | Clinic/Center | 1334 S 18th St, Philadelphia, PA 19146-4647 | 2020-11-01 |
| 1023620135 | Neshoba County General Hospital-nursing Home | Clinic/Center | 406 Stribling St, Philadelphia, MS 39350-3344 | 2020-08-19 |
| 1043775711 | New Vitae, Inc. | Clinic/Center | 27 S. 55th Street, Philadelphia, PA 19139-3247 | 2019-02-06 |
| 1184132219 | Neshoba County General Hospital | Clinic/Center | 1002 Saint Francis Dr, Philadelphia, MS 39350-2030 | 2018-01-10 |
| 1699288142 | Rogers Memorial Hospital Inc | Clinic/Center | 1 Winding Dr Ste 106, Philadelphia, PA 19131-2907 | 2017-11-07 |
| 1952753238 | American Rehabilitation Counseling Center LLC | Clinic/Center | 8305-15 Ridge Ave, Philadelphia, PA 19128-1722 | 2016-07-11 |
| 1750736088 | Mark Wilson | Clinic/Center | 5313 Ogden St, Philadelphia, PA 19139-1438 | 2016-04-23 |
| 1023485265 | Greater Philadelphia Health Action Inc. | Clinic/Center | 1408 S. Broad St., 2nd Floor, Philadelphia, PA 19146-4808 | 2015-08-24 |
| 1407233125 | Rediclinic of Pa, LLC | Clinic/Center | 7418-32 Oxford Avenue, Philadelphia, PA 19111-3023 | 2015-05-01 |
| 1912397118 | Physical Corrective Solutions, LLC | Clinic/Center | 2644 Lefevre St Ste A, Suite A, Philadelphia, PA 19137-1733 | 2015-01-27 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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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.