Organization Active NPI

Transition Phase III

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
National Provider Identifier
1720288913
Registry record updated Apr 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TRANSITION PHASE III
Practice address
3900 City Ave
Madison BLDG Suite 1207
Philadelphia, PA 19131-2908
Phone
(215) 878-3052
Fax
(215) 878-3532
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2010

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

Authorized official

Name
Ms. Jo Benait, PSYD
Title
Ceo Group Administrator
Phone
(215) 878-3052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3900 City Ave
Madison BLDG Suite 1207
Philadelphia, PA 19131-2908

Mailing address

3900 City Avenue
Madison BLDG Suite 1207
Philadelphia, PA 19131-0000
Phone (215) 878-3052

Other identifiers 1

IdentifierTypeStateIssuer
1019569460001MedicaidPA

National Provider Directory

National Provider Directory

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1720288913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 CITY AVENUE",
            "address_2": "MADISON BLDG SUITE 1207",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191310000",
            "telephone_number": "215-878-3052",
            "fax_number": "215-878-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CITY AVE",
            "address_2": "MADISON BLDG SUITE 1207",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312908",
            "telephone_number": "215-878-3052",
            "fax_number": "215-878-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSITION PHASE III",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "BENAIT",
        "authorized_official_first_name": "JO",
        "authorized_official_title_or_position": "CEO GROUP ADMINISTRATOR",
        "authorized_official_telephone_number": "215-878-3052",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019569460001",
            "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 Apr 13, 2010; 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.