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NPI Code Detail

MEDICARE: ALYSSA MAHER LPC, MT-BC

MEDICARE: ALYSSA MAHER LPC, MT-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2225A00000XMusic Therapist14080NY

General Provider Information

NPI Number : 1275190415
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MAHER LPC, MT-BC
Provider Business Mailing Address
First Line : 112 E ALLEN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-4189
Country : US
Telephone Number : 215-278-9444
Fax Number :
Provider Business Practice Location Address
First Line : 112 E ALLEN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-4189
Country : US
Telephone Number : 215-278-9444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2019
Last Update Date : 08/18/2024

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