Provider Demographics
NPI:1851152961
Name:SHI MENTAL HEALTH COUNSELING, LLC
Entity Type:Organization
Organization Name:SHI MENTAL HEALTH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ATIYA
Authorized Official - Middle Name:WALIDA
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:267-977-8273
Mailing Address - Street 1:1027 WAGNER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-2927
Mailing Address - Country:US
Mailing Address - Phone:267-977-8273
Mailing Address - Fax:
Practice Address - Street 1:3502 SCOTTS LN BLDG 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1561
Practice Address - Country:US
Practice Address - Phone:215-703-8573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty