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NPI Code Detail

MEDICARE: GAMUT BEHAVIORAL SERVICES

MEDICARE: GAMUT BEHAVIORAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538465240
Entity Type Code : Organization
Provider Name (Legal Business Name) : GAMUT BEHAVIORAL SERVICES
Provider Business Mailing Address
First Line : 101 E 8TH AVE STE 303
Second Line :
City : CONSHOHOCKEN
State : PA
Zip : 19428-1774
Country : US
Telephone Number : 267-253-5366
Fax Number :
Provider Business Practice Location Address
First Line : 101 E 8TH AVE STE 303
Second Line :
City : CONSHOHOCKEN
State : PA
Zip : 19428-1774
Country : US
Telephone Number : 267-253-5366
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MRS. MARYCATE MCDONOUGH
Credential :
Telephone Number : 267-253-5366
Provider Enumeration Date : 01/28/2011
Last Update Date : 11/14/2024

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Directions to “GAMUT BEHAVIORAL SERVICES ” Practice Location

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