Healthcare Provider Details

I. General information

NPI: 1902444854
Provider Name (Legal Business Name): WILLIAM WELSH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 GRANT AVE
PHILADELPHIA PA
19114-1032
US

IV. Provider business mailing address

503 FLORAL VALE BLVD
YARDLEY PA
19067-5512
US

V. Phone/Fax

Practice location:
  • Phone: 215-878-3400
  • Fax:
Mailing address:
  • Phone: 215-497-0240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-79432
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010102
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: