NPIMap

Organization Active NPI

West Philadelphia Community MH Consortium Inc

  • Adult Mental Health Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1043330442
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
1007155230045 Issued in PA
Legal business name
WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC
Practice address
6408 Woodland Ave
Philadelphia, PA 19142-2323
Phone
(215) 596-8100
Fax
(215) 382-4405
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John F. White Jr.
Title
President Ceo
Phone
(215) 596-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 1007155230045 PA Primary

Addresses

Primary practice location

6408 Woodland Ave
Philadelphia, PA 19142-2323

Mailing address

3801 Market St
Suite 201
Philadelphia, PA 19104-3153
Phone (215) 596-8100

Other identifiers 1

IdentifierTypeStateIssuer
1007155230045MedicaidPA

Other names 1

  • The Consortium Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Consortium Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Locations

6408 Woodland Ave
Philadelphia, PA 19142
Phone (215) 727-4420

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043330442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MARKET ST",
            "address_2": "SUITE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043153",
            "telephone_number": "215-596-8100",
            "fax_number": "215-382-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191422323",
            "telephone_number": "215-596-8100",
            "fax_number": "215-382-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT  CEO",
        "authorized_official_telephone_number": "215-596-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "1007155230045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007155230045",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Consortium Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.