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General NPI Number Information
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NPI Number | 1851772628
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Entity Type | Organization
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Legal Business Name | MAYS FAMILY THERAPY
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 1508 E WINGOHOCKING ST
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City | PHILADELPHIA
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State | PA
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Zip | 19124-3111
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Country | US
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Telephone | 267-252-6653
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 30812
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City | PHILADELPHIA
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State | PA
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Zip | 19104-0812
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | DR. JANEEN CROSS
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Credential | DSW, MSW, MBA, LCSW
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Telephone | 267-252-6653
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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 | CW018164
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License Number State | PA
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