Healthcare Provider Details

I. General information

NPI: 1952875114
Provider Name (Legal Business Name): MCPHERSON CLINICAL & CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2019
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WASHINGTON LN STE 6A
WYNCOTE PA
19095-1400
US

IV. Provider business mailing address

25 WASHINGTON LN STE 6A
WYNCOTE PA
19095-1400
US

V. Phone/Fax

Practice location:
  • Phone: 215-586-3782
  • Fax: 267-435-9039
Mailing address:
  • Phone: 215-586-3782
  • Fax: 267-435-9039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JENNIFER ANNE MCPHERSON
Title or Position: OWNER/CEO
Credential: LPC
Phone: 215-586-3782