NPIMap

Organization Active NPI

Overbrook Therapy Associates

  • Community/Behavioral Health Agency
  • Wilmington, DE
National Provider Identifier
1366622110
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
Q10000903 Issued in DE
Legal business name
OVERBROOK THERAPY ASSOCIATES
Practice address
1015 West 24TH Street
Wilmington, DE 19802
Phone
(302) 834-5433
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Dr. Carissa Y Ferguson, PSY.D, LCSW
Title
President/Ceo
Phone
(215) 510-1063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Q10000903 DE Primary

Addresses

Primary practice location

1015 West 24TH Street
Wilmington, DE 19802

Mailing address

PO Box 53726
Philadelphia, PA 19105-3726
Phone (215) 510-1063

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1366622110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53726",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191053726",
            "telephone_number": "215-510-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WEST 24TH STREET",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19802",
            "telephone_number": "302-834-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERBROOK THERAPY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "215-510-1063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "DE",
            "license": "Q10000903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.