Organization Active NPI

Thomas Jefferson University

Doing business as Thomas Jefferson University Drug and Alcohol Services

  • Public Health or Welfare Agency
  • Philadelphia, PA
National Provider Identifier
1467547968
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
820023 Issued in PA
Legal business name
THOMAS JEFFERSON UNIVERSITY
Doing business as
Thomas Jefferson University Drug and Alcohol Services
Practice address
1021 South 21St Street
Philadelphia, PA 19146
Phone
(215) 735-5979
NPI assigned
Oct 3, 2006
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
THOMAS JEFFERSON UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Dr. Sara M Shane, PSY.D.NPI 1871822031
Title
Executive Director
Phone
(215) 890-6289

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 820023 PA Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU

Addresses

Primary practice location

1021 South 21St Street
Philadelphia, PA 19146

Mailing address

1021 S 21St St
Philadelphia, PA 19146-2634
Phone (215) 890-6277

Other identifiers 1

IdentifierTypeStateIssuer
1007571300083OtherPAMEDICAID

Other names 1

  • Thomas Jefferson University Drug and Alcohol Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Direct Direct

National Provider Directory

National Provider Directory
Part of
Jefferson Community Onc

Locations

1021 S 21st St
Philadelphia, PA 19146
Phone (215) 735-5979

130 S 9th St
Ste 500
Philadelphia, PA 19107
Phone (215) 503-6791

130 S 9th St
Ste 647
Philadelphia, PA 19107
Phone (215) 503-6791

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1467547968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 S 21ST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462634",
            "telephone_number": "215-890-6277",
            "fax_number": "215-790-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 SOUTH 21ST STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19146",
            "telephone_number": "215-735-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS JEFFERSON UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THOMAS JEFFERSON UNIVERSITY",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "SHANE",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-890-6289",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "PA",
            "license": "820023",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "1007571300083",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Direct",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1021 south 21st street",
            "city": "philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Thomas Jefferson University Drug and Alcohol Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 7, 2026; 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.