MAZZONI CENTER (NPI# 1477631307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477631307 |
| Entity Type | Organization |
| Organization Name | MAZZONI CENTER |
| Other Organization Name | PCHA |
| Practice Address |
1348 Bainbridge St Philadelphia PA 19147-1810 |
| Practice Telephone | (215) 563-0652 |
| Practice Fax Number | 2155630664 |
| Mailing Telephone | 2155630652 |
| Mailing Fax Number | 2155630664 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | ALECIA MANLEY (COO) |
| Authorized Official Telephone | 2155630652 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | 807382 | PA | Agencies |
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007555740014 | 05 |
| Other Name | Type Code |
|---|---|
| PCHA | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 809 Locust Street, Philadelphia, PA 191074123 | 2155630658 | 2155630662 |
| 1201 Locust St, Philadelphia, PA 191075409 | 2159859206 | 2159230365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225188428 | Mazzoni Center | Social Worker | 1201 Chestnut St, 2nd Floor, Philadelphia, PA 19107-4123 | 2007-01-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAZZONI CENTER | 1348 Bainbridge St, Philadelphia, PA 19147 |
| Street Address |
1348 BAINBRIDGE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19147-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227666 | Annaliese Mae Hee Kiesnowski | Social Worker | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2020-05-28 |
| 1497378269 | Lisa Phillips | Social Worker | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2020-05-27 |
| 1871115295 | Peter Andrew Danzig | Social Worker | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2020-05-07 |
| 1578183133 | Deborah Claire Saltman | Family Medicine | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2020-04-23 |
| 1083233589 | Ian Mccoy | Social Worker | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2020-04-14 |
| 1780226050 | Alecia Manley | Case Manager/Care Coordinator | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2019-10-08 |
| 1245888288 | Ryan Cocron | Marriage & Family Therapist | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2019-09-03 |
| 1063068294 | Kai Z. Thigpen | Social Worker | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2019-08-13 |
| 1790349835 | Kasey Elise Benchimol | Nurse Practitioner | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2019-04-24 |
| 1922563881 | Sasha Golden | Registered Nurse | 1348 Bainbridge St, Philadelphia, PA 19147-1810 | 2019-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508336181 | Jamica Cropper-pam | Counselor | 401 S 2nd St. Suite 301, Philadelphia, PA 19147 | 2018-11-27 |
| 1598234411 | Halina Dziewolska | Behavioral Analyst | 535 Queen Street, Philadelphia, PA 19147 | 2018-11-20 |
| 1972072908 | City Dental LLC | Clinic/Center | 1100 Washington Ave 2nd Floor, Philadelphia, PA 19147 | 2018-11-20 |
| 1487120218 | Christopher Michael Rosado | Behavioral Analyst | 1218-20 South 8th St, 1, Philadelphia, PA 19147 | 2018-10-19 |
| 1891271722 | Candice Millard | Dietitian, Registered | 419 S 8th St Apt 1b, Philadelphia, PA 19147 | 2018-07-13 |
| 1669998217 | Julianne Leonarda Wiebalk | Counselor | 814 South 4th Street, 1st Floor, Philadelphia, PA 19147 | 2017-08-16 |
| 1396269247 | Sara Parente | Social Worker | 1217 Fitzwater St., Unit A, Philadelphia, PA 19147 | 2017-08-02 |
| 1609398445 | Nikele Riek | Social Worker | 1348 Bainbridge Street, Philadelphia, PA 19147 | 2017-07-13 |
| 1023556875 | Bralow Medical Group | General Practice | 834 South St., Philadelphia, PA 19147 | 2017-02-01 |
| 1194196105 | Ann Courto | Dietitian, Registered | 1140 Cross Street, Philadelphia, PA 19147 | 2015-10-16 |
| Find all providers in zip 19147 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1679043152 | Prevention Point Philadelphia | Family Medicine | 2913-15 Kensington Ave, Philadelphia, PA 19134-3016 | 2018-11-28 |
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| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19147 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.