Provider Demographics
NPI:1013407568
Name:ALBERT, SAMUEL (BA, CIP, CRS)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:ALBERT
Suffix:
Gender:M
Credentials:BA, CIP, CRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 YORK RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2254
Mailing Address - Country:US
Mailing Address - Phone:267-626-2018
Mailing Address - Fax:267-636-5205
Practice Address - Street 1:501 YORK RD UNIT 4 RENEW FAMILY SERVICES LLC
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:267-626-2018
Practice Address - Fax:267-636-5205
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health