Philadelphia Psychotherapy Group

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017668 Issued in PA

Legal business name

PHILADELPHIA PSYCHOTHERAPY GROUP

Practice address

1518 Walnut St Ste 900
Philadelphia, PA 19102

Phone

(215) 720-4800

NPI assigned

Jul 27, 2017

Last updated

Jul 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Grossman, LCSWNPI 1497033823

Title

Owner

Phone

(215) 720-4800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Grossman

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1497033823
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1144744574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST STE 900",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023405",
            "telephone_number": "215-720-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST STE 900",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-720-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA PSYCHOTHERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-720-4800",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philadelphia Post Acute Partners, LLC (Penn Medicine Good Shepherd Rehabilitation)
• Philadelphia Post-Acute Partners LLC (GSPP Physician Group)
• Philadelphia Premium Homecare LLC
• Philadelphia Protestant Home
• Philadelphia Psychological Services
• Philadelphia Radiation Oncology, P.C.
• Philadelphia Recovery Solutions LLC
• Philadelphia Rehab Medc
• Philadelphia Rehabilitation & Sports Medicine
• Philadelphia Retina Associates PC

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.