Provider Demographics
NPI:1073840476
Name:THE AFRITUDE INSTITUTE
Entity Type:Organization
Organization Name:THE AFRITUDE INSTITUTE
Other - Org Name:TAI
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MBETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:215-535-3271
Mailing Address - Street 1:1213 VINE ST
Mailing Address - Street 2:SUITE 117
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1111
Mailing Address - Country:US
Mailing Address - Phone:215-535-3271
Mailing Address - Fax:
Practice Address - Street 1:1213 VINE ST
Practice Address - Street 2:SUITE 117
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1111
Practice Address - Country:US
Practice Address - Phone:215-535-3271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004425101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25254340OtherDRIVER LICENSE NUMBER