| Community Council For Mental Health & Mental Retardation Inc | |
|
4900 Wyalusing Ave Philadelphia PA 19131-5127 | |
| (215) 473-7033 | |
| (215) 827-5276 |
| Full Name | Community Council For Mental Health & Mental Retardation Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4900 Wyalusing Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Rekiya Bell (DIRECTOR OF BILLING/CREDENTIALING) |
| Authorized Official Contact | 2159213713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Council For Mental Health & Mental Retardation Inc 4900 Wyalusing Ave Philadelphia PA 19131-5127 Ph: (215) 473-7033 | Community Council For Mental Health & Mental Retardation Inc 4900 Wyalusing Ave Philadelphia PA 19131-5127 Ph: (215) 473-7033 |
| NPI Number | 1093849986 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 08/20/2024 |
| Certification Date | 08/20/2024 |
| Medicare PECOS PAC ID | 8123003498 |
|---|---|
| Medicare Enrollment ID | O20040621001596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093849986 | NPI | - | NPPES |
| 1000049600021 | Medicaid | PA | |
| 1000049600012 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 121630 (Pennsylvania) | Primary |
| Provider Name | David A Frankel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811052574 PECOS PAC ID: 1355492653 Enrollment ID: I20090626000274 |
| Provider Name | Brigid Bautista |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770639080 PECOS PAC ID: 8325032295 Enrollment ID: I20100323000161 |
| Provider Name | Phyllis J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225320245 PECOS PAC ID: 5092992321 Enrollment ID: I20131212000100 |
| Provider Name | Steven M Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427477041 PECOS PAC ID: 0648494369 Enrollment ID: I20161027001201 |
| Provider Name | James J Nestor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801055611 PECOS PAC ID: 1658615679 Enrollment ID: I20181203001321 |
| Provider Name | Estela A Beale |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386704971 PECOS PAC ID: 9234315052 Enrollment ID: I20190403001558 |
| Provider Name | Afshan Ranjha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851735047 PECOS PAC ID: 3072946318 Enrollment ID: I20191127001738 |
| Provider Name | Asif R Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265637532 PECOS PAC ID: 5991806879 Enrollment ID: I20210326001077 |
| Provider Name | Erica N Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124618335 PECOS PAC ID: 5092124883 Enrollment ID: I20210507000009 |
Solis Physicians Network Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5800 Ridge Ave, Philadelphia, PA 19128 Phone: 215-487-4692 Fax: 215-487-4274 | |
Apm Mental Health Psychiatric Outpatient Clinics Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2921 N 5th St, Philadelphia, PA 19133 Phone: 215-259-3373 Fax: 267-329-9728 | |
University Of Pennsylvania Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3400 Civic Center Blvd, 2 South Pavilion, Philadelphia, PA 19104 Phone: 215-614-1828 | |
The Phil.consultation Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 S 16th St, Philadelphia, PA 19102 Phone: 215-732-8244 Fax: 215-732-8454 | |
Immanuel Care Support Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6641 Dorel St, Philadelphia, PA 19142 Phone: 267-403-8313 | |
Npsyt Psychological Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6327 Burbridge St, Philadelphia, PA 19144 Phone: 215-991-9066 Fax: 215-991-9062 | |
Menergy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7500 Germantown Ave, New Covenant Campus, Elders Hall, Suite 5, Philadelphia, PA 19119 Phone: 215-242-2235 |