NPIMap

Organization Active NPI

West Philadelphia Community Mental Health Consortium, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1891974929
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
1007155230082 Issued in PA
Legal business name
WEST PHILADELPHIA COMMUNITY MENTAL HEALTH CONSORTIUM, INC.
Practice address
5429 Chestnut St
Philadelphia, PA 19139-3300
Phone
(215) 596-8100
NPI assigned
Oct 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1007155230082 PA
Adolescent and Children Mental Health Clinic/Center 261QM0855X 1007155230082 PA Primary

Addresses

Primary practice location

5429 Chestnut St
Philadelphia, PA 19139-3300

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
100715523 0082MedicaidPA

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": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1891974929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MARKET ST",
            "address_2": "SUITE 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": "5429 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393300",
            "telephone_number": "215-596-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PHILADELPHIA COMMUNITY MENTAL HEALTH CONSORTIUM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-596-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "1007155230082",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "1007155230082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100715523 0082",
            "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 Oct 25, 2007; 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.