The Attic Youth Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE ATTIC YOUTH CENTER

Practice address

255 S 16TH St
Philadelphia, PA 19102-3303

Phone

(215) 545-4331

Fax

(215) 545-5774

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Carrie Jacobs, PH.D

Title

Executive Director

Phone

(215) 545-4331

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nghi Phuoc Minh Mai

  • Mental Health Counselor
  • Philadelphia, PA
  • NPI 1811857683
  NPD (past)

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1265697155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 16TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023303",
            "telephone_number": "215-545-4331",
            "fax_number": "215-545-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 16TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023303",
            "telephone_number": "215-545-4331",
            "fax_number": "215-545-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ATTIC YOUTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-545-4331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.