WMC NPI 1114144508

NPI Information

NPI: 1114144508
Provider Name: WMC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4913 N BROAD ST
PHILADELPHIA, PA
ZIP 19141
Phone: (215) 329-3200
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WMC is a mental health counselor in Philadelphia, PA. WMC NPI is 1114144508. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4913 N BROAD ST
PHILADELPHIA, PA
ZIP 19141-215
Phone: (215) 329-3200
Fax: (215) 329-3217

The provider's authorized official is Takisa S Gallman .
The authorized official title is Administrative Director and has the following contact phone number (215) 276-3922.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	192780	PENNSYLVANIA	Yes
2	101YP2500X	Counselor	Professional	192780	PENNSYLVANIA	X
3	103TC0700X	Psychologist	Clinical	192780	PENNSYLVANIA	X
4	174400000X	Specialist		192780	PENNSYLVANIA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0016804930005	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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