Provider Demographics
NPI:1689376261
Name:CELCE, KISHNA
Entity Type:Individual
Prefix:
First Name:KISHNA
Middle Name:
Last Name:CELCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 ALEXANDER AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4402
Mailing Address - Country:US
Mailing Address - Phone:215-987-7485
Mailing Address - Fax:
Practice Address - Street 1:106 GAY ST STE 302
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19127-1309
Practice Address - Country:US
Practice Address - Phone:215-486-1476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171400000XOther Service ProvidersHealth & Wellness Coach