Active NPI
Issa Oumer
- Mental Health Counselor
- Philadelphia, PA
National Provider Identifier
1811351265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- BH0001012
- Practice address
- 810 Tyson Ave
Philadelphia, PA 19111-4429 - Phone
- (267) 304-1805
- NPI assigned
- Apr 12, 2016
- Last updated
- Apr 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | BH0001012 | PA | Primary |
Addresses
Primary practice location
810 Tyson Ave
Philadelphia, PA 19111-4429
Mailing address
810 Tyson Ave
Philadelphia, PA 19111-4429
Phone (267) 304-1805
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
| License | State | Type | Specialty |
|---|---|---|---|
| BH0001012 | PA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460419200000",
"number": "1811351265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 TYSON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191114429",
"telephone_number": "267-304-1805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 TYSON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191114429",
"telephone_number": "267-304-1805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUMER",
"first_name": "ISSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-12",
"last_updated": "2016-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "BH0001012",
"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 Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.