NPIMap

Organization Active NPI

Karen Kevreshe

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1013124189
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CWO15024 Issued in PA
Legal business name
KAREN KEVRESHE
Practice address
417 N 8TH St
402
Philadelphia, PA 19123-3916
Phone
(215) 496-0707
Fax
(215) 627-9042
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Andrea Ettingoff
Title
Director of Clinical Affairs
Phone
(215) 496-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CWO15024 PA Primary

Addresses

Primary practice location

417 N 8TH St
402
Philadelphia, PA 19123-3916

Mailing address

238 S Camac St
3B
Philadelphia, PA 19107-7019
Phone (267) 234-1833

Other names 1

  • Children's Crisis Treatment Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Children'S Crisis Treatment Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

417 N 8th St
Ste 402
Philadelphia, PA 19123
Phone (215) 496-0707

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1013124189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 S CAMAC ST",
            "address_2": "3B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191077019",
            "telephone_number": "267-234-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N 8TH ST",
            "address_2": "402",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233916",
            "telephone_number": "215-496-0707",
            "fax_number": "215-627-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN KEVRESHE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "ETTINGOFF",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL  AFFAIRS",
        "authorized_official_telephone_number": "215-496-0707",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CWO15024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Crisis Treatment Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.