NPIMap

Organization Active NPI

Philly Family Life Counseling, LLC

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1134599608
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PHILLY FAMILY LIFE COUNSELING, LLC
Practice address
1209 Grant Ave
Suite 2F
Philadelphia, PA 19115-3706
Phone
(215) 677-3710
Fax
(215) 673-2701
NPI assigned
Sep 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Authorized official

Name
Dr. Eugene Devers, LCSWNPI 1437428497
Title
Managing Member of LLC
Phone
(215) 554-8191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

1209 Grant Ave
Suite 2F
Philadelphia, PA 19115-3706

Mailing address

1209 Grant Ave
Suite 2F
Philadelphia, PA 19115-3706
Phone (215) 677-3710

Other names 1

  • Philly Family Life Counseling, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1134599608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 GRANT AVE",
            "address_2": "SUITE 2F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153706",
            "telephone_number": "215-677-3710",
            "fax_number": "215-673-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 GRANT AVE",
            "address_2": "SUITE 2F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153706",
            "telephone_number": "215-677-3710",
            "fax_number": "215-673-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY FAMILY LIFE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "DEVERS",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "MANAGING MEMBER OF LLC",
        "authorized_official_telephone_number": "215-554-8191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philly Family Life Counseling, LLC",
            "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 Dec 27, 2016; 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.