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NPI Code Detail

MEDICARE: INNER ALCHEMY PSYCHOTHERAPY, LLC

MEDICARE: INNER ALCHEMY PSYCHOTHERAPY, LLC
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1649101452
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER ALCHEMY PSYCHOTHERAPY, LLC
Provider Business Mailing Address
First Line : 1617 JFK BLVD STE 2000
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1821
Country : US
Telephone Number : 917-673-3867
Fax Number :
Provider Business Practice Location Address
First Line : 1617 JFK BLVD STE 2000
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1821
Country : US
Telephone Number : 917-673-3867
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LORA SASIELA
Credential : LCSW
Telephone Number : 917-673-3867
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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