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NPI Code Detail

MEDICARE: SAVANNA STANTON-AMEISEN MA

MEDICARE:   SAVANNA  STANTON-AMEISEN  MA
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
1101YM0800XMental Health CounselorPC014547PA

General Provider Information

NPI Number : 1902466139
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNA STANTON-AMEISEN MA
Provider Business Mailing Address
First Line : 501 S 54TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19143-1900
Country : US
Telephone Number : 445-428-5800
Fax Number :
Provider Business Practice Location Address
First Line : 501 S 54TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19143-1900
Country : US
Telephone Number : 445-428-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2019
Last Update Date : 04/08/2026

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Directions to “ SAVANNA STANTON-AMEISEN MA” Practice Location

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