NPIMap

Organization Active NPI

Informed Decisions for Seniors, LLC

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1174853196
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016312 Issued in PA
Legal business name
INFORMED DECISIONS FOR SENIORS, LLC
Practice address
2640 Maxwell Street
Philadelphia, PA 19152-1551
Phone
(267) 334-3735
NPI assigned
Jan 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Authorized official

Name
Mr. Charles Christian Whitlock Jr., LCSW
Title
Owner
Phone
(267) 334-3735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CW016312 PA Primary

Addresses

Primary practice location

2640 Maxwell Street
Philadelphia, PA 19152-1551

Mailing address

2640 Maxwell Street
Philadelphia, PA 19152-1551
Phone (267) 334-3735

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1174853196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 MAXWELL STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521551",
            "telephone_number": "267-334-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 MAXWELL STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521551",
            "telephone_number": "267-334-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFORMED DECISIONS FOR SENIORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "WHITLOCK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-334-3735",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016312",
            "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 Jan 14, 2010; 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.