Provider Demographics
NPI:1104655919
Name:FLAM, DAVID (MS, NCC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FLAM
Suffix:
Gender:M
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 BERGEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1921
Mailing Address - Country:US
Mailing Address - Phone:917-848-3822
Mailing Address - Fax:
Practice Address - Street 1:2018 BERGEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1921
Practice Address - Country:US
Practice Address - Phone:917-848-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional