NPIMap

Organization Active NPI

Tag Inspires

  • Marriage & Family Therapist
  • Glenside, PA
National Provider Identifier
1336528744
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MF000813 Issued in PA
Legal business name
TAG INSPIRES
Practice address
309 W Glenside Ave
Glenside, PA 19038-3313
Phone
(215) 558-5616
Fax
(215) 242-2051
NPI assigned
May 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Authorized official

Name
Taniek A Gentles, LMFTNPI 1740688290
Title
Executive Director
Phone
(718) 974-7885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X MF000813 PA Primary

Addresses

Primary practice location

309 W Glenside Ave
Glenside, PA 19038-3313

Mailing address

1810 68TH Ave
Philadelphia, PA 19126-2626
Phone (718) 974-7885

National Provider Directory

National Provider Directory

Locations

309 W Glenside Ave
Glenside, PA 19038
Phone (215) 558-5616

Practitioners & affiliated clinicians

Practitioners 4

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": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1336528744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 68TH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191262626",
            "telephone_number": "718-974-7885",
            "fax_number": "215-242-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W GLENSIDE AVE",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190383313",
            "telephone_number": "215-558-5616",
            "fax_number": "215-242-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAG INSPIRES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "GENTLES",
        "authorized_official_first_name": "TANIEK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-974-7885",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenside, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.