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3319 Kensington Ave Philadelphia PA 19134-1438 | |
| (215) 778-2504 | |
| (215) 426-4437 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3319 Kensington Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Lawrence Joseph Gallagher (PRESIDENT, DIRECTOR) |
| Authorized Official Contact | 2157782504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7410 Dungan Rd Philadelphia PA 19111-3641 Ph: (215) 778-2504 | 3319 Kensington Ave Philadelphia PA 19134-1438 Ph: (215) 778-2504 |
| NPI Number | 1134324742 |
|---|---|
| Provider Enumeration Date | 06/15/2007 |
| Last Update Date | 09/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134324742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 807401 (Pennsylvania) | Primary |
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