NPIMap

Organization Active NPI

Community Council for MH/Mr, Inc.

  • Community Health Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1649377003
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
121630 Issued in PA
Legal business name
COMMUNITY COUNCIL FOR MH/MR, INC.
Practice address
4900 Wyalusing Ave
Philadelphia, PA 19131-5127
Phone
(215) 473-7033
Fax
(215) 473-5405
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Mr. Alex Moore
Title
Ceo
Phone
(215) 473-7033

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Community Health Clinic/Center 261QC1500X 121630 PA Primary

Addresses

Primary practice location

4900 Wyalusing Ave
Philadelphia, PA 19131-5127

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
600003557OtherPAMAGELLAN
100004960MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Community Council36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1649377003",
    "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": "4900 WYALUSING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315127",
            "telephone_number": "215-473-7033",
            "fax_number": "215-473-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNCIL FOR MH/MR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-473-7033",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "PA",
            "license": "121630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600003557",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004960",
            "state": "PA"
        }
    ],
    "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 May 11, 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.