NPIMap

Organization Active NPI

Community Council for Mental Health & Mental Retardation Inc.

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1316579923
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY COUNCIL FOR MENTAL HEALTH & MENTAL RETARDATION INC.
Practice address
1211 Chestnut St FL 8
Philadelphia, PA 19107-4103
Phone
(267) 514-3500
Fax
(267) 514-3783
NPI assigned
Feb 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Authorized official

Name
Rekiya Bell
Title
Director of Billing
Phone
(215) 921-3713

Specialties & licenses 1

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

Addresses

Primary practice location

1211 Chestnut St FL 8
Philadelphia, PA 19107-4103

Mailing address

4900 Wyalusing Ave
Philadelphia, PA 19131-5127
Phone (215) 921-3713

Other names 1

  • Community Council for MH/MR, Inc Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621001596 PA Part B Supplier - Clinic/Group Practice 8123003498 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1316579923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 WYALUSING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315127",
            "telephone_number": "215-921-3713",
            "fax_number": "215-827-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 CHESTNUT ST FL 8",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074103",
            "telephone_number": "267-514-3500",
            "fax_number": "267-514-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNCIL FOR MENTAL HEALTH & MENTAL RETARDATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "REKIYA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "215-921-3713"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Council for MH/MR, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 14, 2020; 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.