NPIMap

Organization Active NPI

Sunshine Therapy Club Inc

  • Social Worker
  • Havertown, PA
National Provider Identifier
1962687319
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
SUNSHINE THERAPY CLUB INC
Practice address
410 W Township Line Rd
Suite 4
Havertown, PA 19083-5237
Phone
(610) 853-9919
Fax
(610) 853-9921
NPI assigned
Jan 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Authorized official

Name
Taraya J Shirdan
Title
Executive Director
Phone
(610) 853-9919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

410 W Township Line Rd
Suite 4
Havertown, PA 19083-5237

Mailing address

410 W Township Line Rd
Suite 4
Havertown, PA 19083-5237
Phone (610) 853-9919

Other identifiers 1

IdentifierTypeStateIssuer
1000061970006MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Sunshine Therapy Club Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458777600000",
    "number": "1962687319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W TOWNSHIP LINE RD",
            "address_2": "SUITE 4",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835237",
            "telephone_number": "610-853-9919",
            "fax_number": "610-853-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W TOWNSHIP LINE RD",
            "address_2": "SUITE 4",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835237",
            "telephone_number": "610-853-9919",
            "fax_number": "610-853-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE THERAPY CLUB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2016-03-24",
        "status": "A",
        "authorized_official_last_name": "SHIRDAN",
        "authorized_official_first_name": "TARAYA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "610-853-9919"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000061970006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.

Verify at the official NPI Registry.