Provider Demographics
NPI:1255590469
Name:GERMANTOWN SETTLEMENT OUTPATIENT WELLNESS COUNSELING CENTER
Entity type:Organization
Organization Name:GERMANTOWN SETTLEMENT OUTPATIENT WELLNESS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS-FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-849-3104
Mailing Address - Street 1:208 W CHELTEN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3803
Mailing Address - Country:US
Mailing Address - Phone:215-849-3104
Mailing Address - Fax:215-843-2618
Practice Address - Street 1:208 W CHELTEN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3803
Practice Address - Country:US
Practice Address - Phone:215-849-3104
Practice Address - Fax:215-843-2618
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GERMANTOWN SETTLEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA128600251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020876680001OtherDPW PROVIDER NUMBER