NPIMap

Organization Active NPI

Equilibria Mental Health Services

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1225792872
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EQUILIBRIA MENTAL HEALTH SERVICES
Practice address
525 S 4TH St Ste 471
Philadelphia, PA 19147-1582
Phone
(267) 861-3685
NPI assigned
Oct 28, 2021
Last updated
Oct 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Authorized official

Name
Daniel James Gomez
Title
Vice President
Phone
(610) 715-8289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

525 S 4TH St Ste 471
Philadelphia, PA 19147-1582

Mailing address

1 Gateview Rd
Wayne, PA 19087-5324
Phone (610) 715-8289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211228001562 PA Part B Supplier - Clinic/Group Practice 5698166783 Receives reassigned benefits from 39 practitioners
Practice locations: Willow Grove, PA; Philadelphia, PA; Media, PA; Lafayette Hill, PA; Broomall, PA

National Provider Directory

National Provider Directory

Locations

2004 Sproul Rd
Ste 206
Broomall, PA 19008

632 Germantown Pike
Lafayette Hill, PA 19444
Phone 26786136851

1516 N 5th St
Unit 401
Philadelphia, PA 19122

525 S 4th St
Ste 471
Philadelphia, PA 19147
Phone (215) 861-3685

630 Fitzwatertown Rd
Ste A1
Willow Grove, PA 19090
Phone (215) 658-4553

Practitioners & affiliated clinicians

Practitioners 95

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.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1225792872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GATEVIEW RD",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190875324",
            "telephone_number": "610-715-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 4TH ST STE 471",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471582",
            "telephone_number": "267-861-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIA MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "610-715-8289"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 Oct 28, 2021; 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.