NPIMap

Organization Active NPI

West Philadelphia Community Mental Health Consortium Inc.

  • Clinical Child & Adolescent Psychologist
  • Philadelphia, PA
National Provider Identifier
1871756486
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Legal business name
WEST PHILADELPHIA COMMUNITY MENTAL HEALTH CONSORTIUM INC.
Practice address
2020 Pennsylvania Ave
Philadelphia, PA 19130-3832
Phone
(215) 596-8100
Fax
(215) 382-4405
NPI assigned
Jul 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mr. John F White Jr.
Title
President/Ceo
Phone
(215) 596-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X Primary

Addresses

Primary practice location

2020 Pennsylvania Ave
Philadelphia, PA 19130-3832

Mailing address

3801 Market Street
201
Philadelphia, PA 19104-3153
Phone (215) 596-8100

Other identifiers 1

IdentifierTypeStateIssuer
1007155230073MedicaidPA

Other names 1

  • The Consortium Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Consortium Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1871756486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MARKET STREET",
            "address_2": "201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043153",
            "telephone_number": "215-596-8100",
            "fax_number": "215-382-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PENNSYLVANIA AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303832",
            "telephone_number": "215-596-8100",
            "fax_number": "215-382-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PHILADELPHIA COMMUNITY MENTAL HEALTH CONSORTIUM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "215-596-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007155230073",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Consortium Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 3, 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.