NPIMap

Organization Active NPI

Philadelphia Mental Health Clinic

  • Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1760644744
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
123880 Issued in PA
Legal business name
PHILADELPHIA MENTAL HEALTH CLINIC
Practice address
1235 Pine St
Philadelphia, PA 19107-5945
Phone
(215) 735-9379
Fax
(215) 735-8806
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Mr. Allen Anderson
Title
Director Billing/PC Systems
Phone
(215) 735-5674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 123880 PA Primary

Addresses

Primary practice location

1235 Pine St
Philadelphia, PA 19107-5945

Mailing address

1235 Pine St
Philadelphia, PA 19107-5945
Phone (215) 735-9379

Other identifiers 3

IdentifierTypeStateIssuer
1007279540005MedicaidPA
265050000OtherPAMAGELLAN
000138598OtherPABC

Other names 1

  • Philadelphia Mental Health Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Phila Mental Health Cli3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1760644744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 PINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075945",
            "telephone_number": "215-735-9379",
            "fax_number": "215-735-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 PINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075945",
            "telephone_number": "215-735-9379",
            "fax_number": "215-735-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA MENTAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "DIRECTOR BILLING/PC SYSTEMS",
        "authorized_official_telephone_number": "215-735-5674",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "123880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007279540005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "265050000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "000138598",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philadelphia Mental Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 30, 2008; 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.