Organization · Type 2 NPI

WMC

Specialist · Philadelphia, PA

NPI number 1114144508 Active

Practice location

4913 N Broad St
Philadelphia, PA 19141-2215

Call (215) 329-3200 Map

Fax (215) 329-3217

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X192780 (PA)
Professional Counselor 101YP2500X192780 (PA)
Clinical Psychologist 103TC0700X192780 (PA)
Specialist Primary 174400000X192780 (PA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

2 other providers at this address

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About NPI 1114144508

WMC's National Provider Identifier is 1114144508, issued on Apr 19, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 11, 2025.