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General NPI Number Information
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NPI Number | 1568006849
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Entity Type | Organization
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Legal Business Name | NEXT LEVEL TALK THERAPY LLC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 6801 N BROAD ST
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City | PHILA
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State | PA
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Zip | 19126-2802
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Country | US
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Telephone | 215-668-6446
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Fax | 267-766-6214
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Provider Business Mailing Address
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Address Line | 6801 N BROAD ST
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City | PHILA
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State | PA
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Zip | 19126-2802
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Country | US
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Telephone | 215-668-6446
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Fax | 267-766-6214
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Authorized Official
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Title or Position | FOUNDER
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Name | MR. LEVIS W KENNEY SR.
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Credential | LPC
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Telephone | 215-668-6446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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