NPIMap

Organization Active NPI

Northeast Community Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
National Provider Identifier
1902947211
Registry record updated Nov 9, 2007
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OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(7) exclusion effective Oct 16, 2018.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
105610 Issued in PA
Legal business name
NORTHEAST COMMUNITY MENTAL HEALTH CENTER, INC.
Practice address
2152 N Front St
Philadelphia, PA 19122-1705
Phone
(484) 221-9136
Fax
(484) 221-9130
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Melissa Ann Chlebowski
Title
Ceo
Phone
(484) 221-9136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 105610 PA Primary

Addresses

Primary practice location

2152 N Front St
Philadelphia, PA 19122-1705

Mailing address

2030 W Tilghman St
Suite 105B
Allentown, PA 18104-4354
Phone (484) 221-9136

Other identifiers 2

IdentifierTypeStateIssuer
1007295290002OtherPACOMMUNITY BEHAVIORAL HEAL
1007295290002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

2152 N Front St
Philadelphia, PA 19122
Phone (215) 291-9392

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1902947211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W TILGHMAN ST",
            "address_2": "SUITE 105B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044354",
            "telephone_number": "484-221-9136",
            "fax_number": "484-221-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221705",
            "telephone_number": "484-221-9136",
            "fax_number": "484-221-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "CHLEBOWSKI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-221-9136"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "105610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BEHAVIORAL HEAL",
            "identifier": "1007295290002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007295290002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.