Healthcare Provider Details

I. General information

NPI: 1275190415
Provider Name (Legal Business Name): ALYSSA MAHER LPC, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 08/18/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E ALLEN ST
PHILADELPHIA PA
19125-4189
US

IV. Provider business mailing address

112 E ALLEN ST
PHILADELPHIA PA
19125-4189
US

V. Phone/Fax

Practice location:
  • Phone: 215-278-9444
  • Fax:
Mailing address:
  • Phone: 215-278-9444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number14080
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: