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General NPI Number Information
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NPI Number | 1447294186
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Entity Type | Organization
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Legal Business Name | GREATER PHILA HEALTH ACTION, INC.
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 1401 S. 4TH STREET 4TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19147-5948
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Country | US
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Telephone | 215-339-1029
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Fax | 215-952-6966
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Provider Business Mailing Address
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Address Line | 1401 S. 31ST STREET 2ND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19146-3506
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Country | US
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Telephone | 215-925-2400
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Fax | 215-925-9162
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SPEC.
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Name | MS. D TINA SMITH
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Credential |
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Telephone | 215-925-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2080C0008X
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Taxonomy Name | Child Abuse Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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