SHADANA DAVIS, PSYD PLLC (NPI# 1912531633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912531633 |
| Entity Type | Organization |
| Organization Name | SHADANA DAVIS, PSYD PLLC |
| Practice Address |
100 W Evergreen Ave Philadelphia PA 19118-3814 |
| Mailing Address |
1044 E Sedgwick St Philadelphia PA 19150-3021 |
| Practice Telephone | 2672821175 |
| Practice Fax Number | 2672821084 |
| Mailing Telephone | 2672500466 |
| Mailing Fax Number | 2672821084 |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |
| Authorized Official Name | DR. SHADANA DAVIS (PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 2672500466 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
100 W EVERGREEN AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19118-3814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477587467 | Gloria D Rohlfs | Social Worker | 100 W Evergreen Ave, Philadelphia, PA 19118-3814 | 2006-07-10 |
| 1275674350 | William John O'donnell | Psychologist | 100 W Evergreen Ave, Philadelphia, PA 19118-3814 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801380126 | Bridget Hirsch | Psychologist | 18 E Abington Avenue, Philadelphia, PA 19118 | 2018-06-20 |
| 1740719194 | Alyssa H Bloch | Speech-Language Pathologist | 8431 Germantown Avenue, Philadelphia, PA 19118 | 2017-06-08 |
| 1710344056 | Zachary Roberts | Physical Therapist | 19 West Highland Avenue, Philadelphia, PA 19118 | 2016-01-18 |
| 1164847810 | Judith Maxwell | Family Medicine | 415 West Mermaid Ln, Philadelphia, PA 19118 | 2014-03-04 |
| 1174963151 | Deborah Hope Cooper | Counselor | 22 E. Chestnut Hill Avenue, Samaritan Counseling Service, Philadelphia, PA 19118 | 2013-07-05 |
| 1730524349 | Breast-pump-rental.com | Durable Medical Equipment & Medical Supplies | 112 W Gravers Lane, Philadelphia, PA 19118 | 2013-05-09 |
| 1083964902 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 7700 Crittenden Ave., Philadelphia, PA 19118 | 2012-09-18 |
| 1215286679 | Jessica M Steedle | Speech-Language Pathologist | 102 East Mermaid Lane, Philadelphia, PA 19118 | 2012-08-31 |
| 1083960124 | Fahad Malik Akhtar | Family Medicine | 8815 Germantown Avenue, 5th Floor, Philadelphia, PA 19118 | 2012-07-26 |
| 1992026793 | Valerie Mikula Hughes | Dentist | 9 E. Highland Ave, Philadelphia, PA 19118 | 2010-06-15 |
| Find all providers in zip 19118 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073924 | Childfirst Services, Inc. | Clinic/Center | 2021 N 63rd St Ste 300, Philadelphia, PA 19151-2609 | 2020-05-06 |
| 1760002000 | Spilove Philadelphia, LLC | Clinic/Center | 1601 Walnut St Ste 1007, Philadelphia, PA 19102-2906 | 2020-04-16 |
| 1144856915 | Text and Online Counseling | Clinic/Center | 3900 City Ave Apt M802, Philadelphia, PA 19131-5701 | 2020-03-12 |
| 1750926028 | Forward Psychotherapy, LLC | Clinic/Center | 100 S Broad St Ste 920, Philadelphia, PA 19110-1016 | 2019-11-11 |
| 1184279598 | Patricia Ventura Lcsw | Clinic/Center | 255 S 17th St Ste 1601, Philadelphia, PA 19103-6216 | 2019-08-03 |
| 1568932085 | Well Tied Knot LLC | Clinic/Center | 6703 Germantown Ave # 210-3, Philadelphia, PA 19119-2109 | 2018-11-27 |
| 1306376280 | Port Richmond Counseling Practices | Clinic/Center | 3110 Aramingo Ave, Suite 1, Philadelphia, PA 19134 | 2017-06-14 |
| 1346621448 | Belmont Behavioral Hospital, LLC | Clinic/Center | 11600 Caroline Rd, Philadelphia, PA 19154-2110 | 2015-06-15 |
| 1720429608 | Raices Pastoral Counseling and Human Development Center, Inc | Clinic/Center | 6001 Colgate St, Philadelphia, PA 19111-6004 | 2013-07-09 |
| 1659658938 | Family Behavioral and Mental Health Center, Inc. | Clinic/Center | 3040 Kensington Ave, Philadelphia, PA 19134-2416 | 2011-11-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19118 |
Please comment or provide details below to improve the information on SHADANA DAVIS, PSYD PLLC.
| 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.