WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC. NPI 1053438390

NPI Information

NPI: 1053438390
Provider Name: WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC.

Doing Business As: THE CONSORTIUM INC.

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
26 S 40TH ST
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 596-8300
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WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC. is an adolescent and children mental health clinic center in Philadelphia, PA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC. NPI is 1053438390. The provider is registered as an organization entity type.
The provider Is Doing Business As The Consortium Inc..

The provider's business location address is:

26 S 40TH ST
PHILADELPHIA, PA
ZIP 19104-009
Phone: (215) 596-8300
Fax: (215) 382-4405

The provider's authorized official is John F White .
The authorized official title is PRESIDENT CEOCeo and has the following contact phone number (215) 596-8100.

The enumeration date for this NPI number is 3/23/2007 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	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	128620	PENNSYLVANIA	Yes

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	1007155230068	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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