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Organization
NORTHEAST BEHAVIORAL MEDICINE INC.
Active
Organization
NORTHEAST BEHAVIORAL MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK F NELSON JR. (PROVIDER RELATIONS)
(215) 904-8748
Entity
Organization
Contact information
Practice address
6800 CASTOR AVE, SUITE D, PHILADELPHIA, PA 19149-2100
(215) 904-8748
(215) 904-8691
Mailing address
6800 CASTOR AVE, SUITE D, PHILADELPHIA, PA 19149-2100
(215) 904-8748
(215) 904-6891
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
Other
Enumeration date
08/27/2009
Last updated
06/22/2010
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