Earth Witness Therapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EARTH WITNESS THERAPY LLC

Practice address

1355 S Markoe St
Philadelphia, PA 19143-3811

Phone

(445) 895-1544

NPI assigned

Jun 18, 2024

Organization subpart

No

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

Authorized official

Name

Christopher Moore, LCSWNPI 1073352001

Title

Owner

Phone

(445) 895-1544

Specialties & licenses 3

Addresses

Practitioners 1

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

• Christopher J Moore, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1073352001
  NPD Authorized official

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1992548747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 S MARKOE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191433811",
            "telephone_number": "732-890-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 S MARKOE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191433811",
            "telephone_number": "445-895-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH WITNESS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "445-895-1544",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Earl, LPC, NCC, BC-DMT
• Linda A Earle, M.D.
• Earnest Heart Home Care LLC
• Elizabeth Earnshaw, LMFT
• Earth Angels Home Care Agency
• Earthly Finds LLC
• Yvonne Eason-Bingham
• Ansu S Eason
• Herman L. Eason Jr., P.A.
• Caroline C Easow, CPNP-AC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.