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General NPI Number Information
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NPI Number | 1255814133
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Entity Type | Organization
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Legal Business Name | AMK ENTERPRISES
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 1601 WALNUT ST STE 1005
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2906
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Country | US
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Telephone | 267-317-8817
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Fax |
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Provider Business Mailing Address
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Address Line | 626 GLEN ECHO RD STE 350B
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City | PHILADELPHIA
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State | PA
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Zip | 19119-2918
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Country | US
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Telephone | 215-285-1084
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ALISA M KAMIS-BRINDA
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Credential | LCSW, LCADC
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Telephone | 215-285-1084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW014987
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License Number State | PA
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