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General NPI Number Information
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NPI Number | 1952360877
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Entity Type | Organization
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Legal Business Name | THERAPY CENTER OF PHILADELPHIA
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 215 S BROAD ST STE 302
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5325
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Country | US
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Telephone | 215-567-1111
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Fax | 223-233-0356
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Provider Business Mailing Address
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Address Line | 215 S BROAD ST STE 302
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5325
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Country | US
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Telephone | 215-567-1111
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Fax | 223-233-0356
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARQUITA BOLDEN
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Credential | MSW, LCSW, RSW
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Telephone | 215-567-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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