Melanin Mommy Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MELANIN MOMMY THERAPY

Practice address

4211 Woodland Ave Apt 305
Drexel Hill, PA 19026-3929

Phone

(717) 491-3666

Fax

(267) 433-3994

NPI assigned

Nov 8, 2022

Organization subpart

No

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

Authorized official

Name

Karina Bailey, LPC

Title

Owner/Ceo

Phone

(610) 675-3733

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1245948272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 WOODLAND AVE APT 305",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263929",
            "telephone_number": "717-491-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 WOODLAND AVE APT 305",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263929",
            "telephone_number": "717-491-3666",
            "fax_number": "267-433-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELANIN MOMMY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "KARINA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "610-675-3733",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Admin@melaninmommytherapy.com",
            "affiliation": "N",
            "endpointDescription": "General office email",
            "address_1": "4211 Woodland Ave Apt 305",
            "city": "Drexel Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190263929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.