Healthcare Provider Details

I. General information

NPI: 1477244267
Provider Name (Legal Business Name): TRIUMPH THERAPEUTIC & CONSULTING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 10/16/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 GEORGETOWN ROAD
WRIGHTSTOWN NJ
08562
US

IV. Provider business mailing address

45 E CITY AVENUE #1954
BALA CYNWYD PA
19004-2421
US

V. Phone/Fax

Practice location:
  • Phone: 267-931-8824
  • Fax:
Mailing address:
  • Phone: 267-931-8824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. STACY ALLISON TRIUMPH
Title or Position: CEO/MANAGING MEMBER
Credential: LCSW
Phone: 267-931-8824