Active NPI
WMC
- Mental Health Counselor
- Philadelphia, PA
National Provider Identifier
1821215203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 192780
- Legal business name
- WMC
- Practice address
- 1939 S Juniper St
Philadelphia, PA 19148-2217 - Phone
- (215) 271-5822
- Fax
- (215) 271-5881
- NPI assigned
- Apr 19, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Takisa S Gallman
- Title
- Administrative Director
- Phone
- (215) 276-3922
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 192780 | PA | Primary |
Addresses
Primary practice location
1939 S Juniper St
Philadelphia, PA 19148-2217
Mailing address
1939 S Juniper St
Philadelphia, PA 19148-2217
Phone (215) 271-5822
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016804930002 | Medicaid | PA | |
| 0016804930004 | Medicaid | PA |
National Provider Directory
National Provider Directory- Tax ID family
- WMC
Other organizations with this tax ID 7
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialist
- Philadelphia, PA
- NPI 1114144508
-
- Community/Behavioral Health Agency
- Philadelphia, PA
- NPI 1144873126
-
- Community/Behavioral Health Agency
- Philadelphia, PA
- NPI 1275186207
-
- Community/Behavioral Health Agency
- Philadelphia, PA
- NPI 1306468756
-
- Community/Behavioral Health Agency
- Philadelphia, PA
- NPI 1659924678
-
- Community/Behavioral Health Agency
- Philadelphia, PA
- NPI 1659993509
-
- Professional Counselor
- Philadelphia, PA
- NPI 1871710269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1821215203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1939 S JUNIPER ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191482217",
"telephone_number": "215-271-5822",
"fax_number": "215-271-5881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1939 S JUNIPER ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191482217",
"telephone_number": "215-271-5822",
"fax_number": "215-271-5881"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WMC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-19",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GALLMAN",
"authorized_official_first_name": "TAKISA",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
"authorized_official_telephone_number": "215-276-3922",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "192780",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016804930002",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016804930004",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.