Provider Demographics
NPI:1447439781
Name:CPA: CONSULTING PSYCHOTHERAPY ASSOCIATES
Entity type:Organization
Organization Name:CPA: CONSULTING PSYCHOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:PROF
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:SHAITELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CAGS, LPC
Authorized Official - Phone:609-929-8136
Mailing Address - Street 1:516 GERHARD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:516 GERHARD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1632
Practice Address - Country:US
Practice Address - Phone:609-929-8136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
70924251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC 004751OtherPA LICENSED PROF. COUN.
70924OtherNBCC