Active NPI
Taja Peterkin-McLean
- Professional Counselor
- Philadelphia, PA
National Provider Identifier
1023504347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 010542
- Practice address
- 6703 Germantown Ave Ste 200
Philadelphia, PA 19119-2109 - Phone
- (267) 540-8585
- NPI assigned
- Jul 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 010542 | PA | Primary |
Addresses
Primary practice location
6703 Germantown Ave Ste 200
Philadelphia, PA 19119-2109
Mailing address
3403 Stanwood St
Philadelphia, PA 19136-2325
Phone (267) 690-1433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010542 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531180800000",
"number": "1023504347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3403 STANWOOD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191362325",
"telephone_number": "267-690-1433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6703 GERMANTOWN AVE STE 200",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191192109",
"telephone_number": "267-540-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERKIN-MCLEAN",
"first_name": "TAJA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-10",
"last_updated": "2018-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "010542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.