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General NPI Number Information
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NPI Number | 1851152961
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Entity Type | Organization
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Legal Business Name | SHI MENTAL HEALTH COUNSELING, LLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 3502 SCOTTS LN BLDG 1
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1561
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Country | US
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Telephone | 215-703-8573
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 WAGNER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19141-2927
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Country | US
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Telephone | 267-977-8273
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. ATIYA WALIDA POPE
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Credential | LPC
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Telephone | 267-977-8273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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