1447439781 NPI number — CPA: CONSULTING PSYCHOTHERAPY ASSOCIATES

Table of content: (NPI 1447439781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447439781 NPI number — CPA: CONSULTING PSYCHOTHERAPY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CPA: CONSULTING PSYCHOTHERAPY ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447439781
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
516 GERHARD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19128-1632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
516 GERHARD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19128-1632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-929-8136
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SHAITELMAN
Authorized Official First Name:
AMY
Authorized Official Middle Name:
MICHELE
Authorized Official Title or Position:
CLINICIAN
Authorized Official Telephone Number:
609-929-8136

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  70924 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PC 004751 . This is a "PA LICENSED PROF. COUN." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 70924 . This is a "NBCC" identifier . This identifiers is of the category "OTHER".




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