Heather Mcgonigle, | |
4700 Wissahickon Ave Ste 118, Philadelphia, PA 19144-4248 | |
(267) 597-3600 | |
Not Available |
Full Name | Heather Mcgonigle |
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Gender | Female |
Speciality | Counselor |
Location | 4700 Wissahickon Ave Ste 118, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1255842241 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
101Y00000X | Counselor | PC001362 (Pennsylvania) | Primary |
Entity Name | Survivors Of Abuse In Recovery Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154386696 PECOS PAC ID: 1850294067 Enrollment ID: O20040127000770 |
Mailing Address | Practice Location Address |
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Heather Mcgonigle, 4700 Wissahickon Ave Ste 119, Philadelphia, PA 19144-4248 Ph: () - | Heather Mcgonigle, 4700 Wissahickon Ave Ste 118, Philadelphia, PA 19144-4248 Ph: (267) 597-3600 |
Dr. Larisa Surenovna Dzhavakova, M.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 A Grant Ave, Philadelphia, PA 19115 Phone: 215-464-3838 Fax: 215-464-3899 | |
Lorraine Braxton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4900 Wyalusing Ave, Philadelphia, PA 19131 Phone: 215-473-7033 | |
Mr. David Joel Silbermann, M.ED, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 8001 Roosevelt Blvd, Suite 205-207, Philadelphia, PA 19152 Phone: 215-332-1914 Fax: 215-332-1873 | |
Ms. Nicole Ivory Goicuria, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2514 N Broad St, Philadelphia, PA 19132 Phone: 215-599-2808 Fax: 215-599-1041 | |
Lori L Reyes, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2927 N 5th St, Philadelphia, PA 19133 Phone: 484-221-9136 Fax: 484-221-9130 | |
Gloria I Jimenez, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2152 N Front St, Philadelphia, PA 19122 Phone: 484-221-9136 Fax: 484-221-9130 | |
Ms. Bernice B Tett, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1734 S Chadwick St, Philadelphia, PA 19145 Phone: 484-300-8699 |