Provider Demographics
NPI:1801012711
Name:THE ART OF FRIENDSHIP SOCIAL SKILLS PROGRAM, PC
Entity Type:Organization
Organization Name:THE ART OF FRIENDSHIP SOCIAL SKILLS PROGRAM, PC
Other - Org Name:CHILD AND FAMILY ART THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR-BC, LPC
Authorized Official - Phone:610-649-1080
Mailing Address - Street 1:600 HAVERFORD RD STE G101
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1139
Mailing Address - Country:US
Mailing Address - Phone:610-649-1080
Mailing Address - Fax:610-649-0503
Practice Address - Street 1:600 HAVERFORD RD STE G101
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1139
Practice Address - Country:US
Practice Address - Phone:610-649-1080
Practice Address - Fax:610-649-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001526101YM0800X
101YM0800X, 221700000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty