MEDICARE: MCPHERSON CLINICAL & CONSULTING 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
1	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1952875114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCPHERSON CLINICAL & CONSULTING SERVICES

Provider Business Mailing Address
First Line	:	25 WASHINGTON LN STE 6A
Second Line	:
City	:	WYNCOTE
State	:	PA
Zip	:	19095-1400
Country	:	US
Telephone Number	:	215-586-3782
Fax Number	:	267-435-9039

Provider Business Practice Location Address
First Line	:	25 WASHINGTON LN STE 6A
Second Line	:
City	:	WYNCOTE
State	:	PA
Zip	:	19095-1400
Country	:	US
Telephone Number	:	215-586-3782
Fax Number	:	267-435-9039

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	JENNIFER ANNE MCPHERSON
Credential	:	LPC
Telephone Number	:	215-586-3782

Provider Enumeration Date	:	01/21/2019
Last Update Date	:	11/11/2021

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