WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC. (NPI# 1902926306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902926306 |
| Entity Type | Organization |
| Organization Name | WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC. |
| Other Organization Name | THE CONSORTIUM INC. |
| Practice Address |
1801 Vine St Family Court Philadelphia PA 19103-1117 |
| Mailing Address |
3801 Market St Suite 201 Philadelphia PA 19104-3153 |
| Practice Telephone | 2155968100 |
| Practice Fax Number | 2153824405 |
| Mailing Telephone | 2155968100 |
| Mailing Fax Number | 2153824405 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN F. WHITE JR. (PRESIDENT CEO) |
| Authorized Official Telephone | 2155968100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1007155230074 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007155230074 | 05 |
| Other Name | Type Code |
|---|---|
| The Consortium Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528186087 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 2501 S 63rd St, Thomas Morton Elementary School, Philadelphia, PA 19142-3101 | 2007-03-26 |
| 1386761971 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 5700 Willows Ave, Philadelphia, PA 19143-4517 | 2007-03-26 |
| 1609993096 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 1200 W Allegheny Ave, Philadelphia, PA 19133-1307 | 2007-03-23 |
| 1699892935 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 4300 Westminster Ave, Philadelphia, PA 19104-1308 | 2007-03-23 |
| 1588786487 | West Philadelphia Community Mh Consortium Inc. | Psychiatry & Neurology | 1801 Vine St, Philadelphia, PA 19103-1117 | 2007-04-04 |
| 1134249535 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 451 S University Ave, Philadelphia, PA 19104-4544 | 2007-03-30 |
| 1952421356 | West Philadelphia Community Mh Consortium Inc. | Clinic/Center | 26 S 40th St, Third Floor, Philadelphia, PA 19104-3009 | 2007-03-30 |
| 1225158660 | West Philadelphia Community Mh Consortium Inc. | Community/Behavioral Health | 26 S 40th St, Second Floor, Philadelphia, PA 19104-3009 | 2007-03-30 |
| 1245350081 | West Philadelphia Community Mh Consortium Inc. | Community/Behavioral Health | 451 S University Ave, Philadelphia, PA 19104-4544 | 2007-03-29 |
| 1174643910 | West Philadelphia Community Mh Consortium Inc. | Community/Behavioral Health | 4601 Market St, Suite 426, Philadelphia, PA 19139-4616 | 2007-03-29 |
| Street Address |
1801 VINE ST FAMILY COURT |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19103-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225184468 | Cornelius Furgueson | Clinical Neuropsychologist | 1801 Vine St, Room 149-mg, Philadelphia, PA 19103-1117 | 2007-01-27 |
| 1952729725 | Barry Zakireh | Psychologist | 1801 Vine St, Room 101, Philadelphia, PA 19103-1117 | 2014-03-31 |
| 1588786487 | West Philadelphia Community Mh Consortium Inc. | Psychiatry & Neurology | 1801 Vine St, Philadelphia, PA 19103-1117 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565431 | Allyson Caputa | Behavior Technician | 100 North 18th Street, Suite 300, Philadelphia, PA 19103 | 2020-10-13 |
| 1063062685 | Sarah Seeling | Social Worker | 255 South 17th Street Suite 1010, Suite 1500, Suite 23, Philadelphia, PA 19103 | 2019-09-16 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1932761863 | Barclay Prescription Pharmacy | Pharmacist | 1736 Spruce St, Phila, PA 19103 | 2019-07-01 |
| 1265910459 | Whitney Sue Fricke | Counselor | 2211 Locust St, Philadelphia, PA 19103 | 2018-07-31 |
| 1740784586 | Sara Elizabeth Macintyre | Speech-Language Pathologist | 1845 Walnut Street Suite 1540, Philadelphia, PA 19103 | 2018-03-19 |
| 1326578907 | Danielle D Bercovitch | Speech-Language Pathologist | 1930 S Broad, Philadelphia, PA 19103 | 2017-06-15 |
| 1598114449 | Brooke Elaine Mullen | Dietitian, Registered | 1708 Pine St Apt 1r, Philadelphia, PA 19103 | 2016-06-10 |
| 1972966026 | Alexandra Brady Jatzke | Dietitian, Registered | 1835 Market St Fl 2, Philadelphia, PA 19103 | 2016-04-05 |
| 1932574118 | David Clements Iv | Psychiatry & Neurology | 1845 Walnut St Ste 1540, Philadelphia, PA 19103 | 2015-12-14 |
| Find all providers in zip 19103 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578937 | Margaret Edwards | Psychologist | 110 S 20th St Ste 206, Philadelphia, PA 19103-4486 | 2020-11-03 |
| 1699374843 | Elizabeth Ann Johnson | Psychologist | 3640 Stanton St Apt 107, Philadelphia, PA 19129-1683 | 2020-10-20 |
| 1689272577 | Katherine Piselli | Psychologist | 3401 Market St Ofc 3216, Philadelphia, PA 19104-3318 | 2020-10-13 |
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1659980621 | Corinne Masur | Psychologist | 1601 Walnut St Ste 1408, Philadelphia, PA 19102-2909 | 2020-07-27 |
| 1730798067 | Amanda Marie Large | Psychologist | 1516 N 5th St Unit 401, Philadelphia, PA 19122-3679 | 2020-07-22 |
| 1295355543 | Jennifer Ann Engelhardt | Psychologist | 8201 Henry Ave Apt Q15, Philadelphia, PA 19128-2248 | 2020-04-16 |
| 1336778315 | Carly Mirit Gerbi | Psychologist | 2227 Delancey Pl, Philadelphia, PA 19103-6549 | 2020-04-02 |
| 1811530512 | Tower Drexel Academic Medical Group LLC | Psychologist | 1427 Vine St Fl 1, Philadelphia, PA 19102-1031 | 2019-10-25 |
| 1003459702 | Tower Drexel Academic Medical Group LLC | Psychologist | 4700 Wissahickon Ave Ste C102, Philadelphia, PA 19144-4248 | 2019-10-25 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19103 |
Please comment or provide details below to improve the information on WEST PHILADELPHIA COMMUNITY MH 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.