Individual provider Active NPI

Kyra Johana Sjarif

  • Counselor
  • Philadelphia, PA
National Provider Identifier
1477163327
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
PC012595 Issued in PA
Practice address
255 S 17TH St Ste 2121
Philadelphia, PA 19103-6211
Phone
(267) 603-1203
NPI assigned
Aug 5, 2020
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X PC012595 PA Primary

Addresses

Primary practice location

255 S 17TH St Ste 2121
Philadelphia, PA 19103-6211

Mailing address

709 S Marvine St
Philadelphia, PA 19147-1913
Phone (510) 371-3073

Other practice location 1

1819 JFK Blvd Ste 302
Philadelphia, PA 19103-1729
Phone (610) 265-3400

Other practice location 2

325 Cherry St
Philadelphia, PA 19106-2061
Phone (215) 847-6749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC012595PAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kyra Sjarif LLC Counselor CurrentSince Jun 23, 2024 Accepting new patients
Peacetree Counseling and Consulting LLC PastSince Aug 1, 2020 Accepting new patients
Amanda E. White Therapy for Women PastSince Oct 11, 2020 Accepting new patients

Locations

255 S 17th St
Ste 2121
Philadelphia, PA 19103
Phone (215) 735-3490

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1477163327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 S MARVINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471913",
            "telephone_number": "510-371-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 2121",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036211",
            "telephone_number": "267-603-1203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 JFK Blvd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191031729",
            "country_code": "US",
            "telephone_number": "610-265-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191062061",
            "country_code": "US",
            "telephone_number": "215-847-6749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SJARIF",
        "first_name": "KYRA",
        "middle_name": "JOHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "PC012595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 8, 2024; 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.