Healthcare Provider Details

I. General information

NPI: 1518056159
Provider Name (Legal Business Name): WIVES SELF HELP FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 ROOSEVELT BLVD 205-207
PHILADELPHIA PA
19152-3038
US

IV. Provider business mailing address

8001 ROOSEVELT BLVD 205-207
PHILADELPHIA PA
19152-3038
US

V. Phone/Fax

Practice location:
  • Phone: 215-332-1914
  • Fax: 215-332-1873
Mailing address:
  • Phone: 215-332-1914
  • Fax: 215-332-1873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number130640
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number130640
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number130640
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number130640
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number130640
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number130640
License Number StatePA
# 7
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number130640
License Number StatePA

VIII. Authorized Official

Name: MS. GAIL SAHL
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 215-332-1914