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Organization
THOMAS JEFFERSON UNIVERSITY
Active
Organization
THOMAS JEFFERSON UNIVERSITY
Active
Parent organization
THOMAS JEFFERSON UNIVERSITY
Other names
Thomas Jefferson University Drug and Alcohol Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
THOMAS JEFFERSON UNIVERSITY
Authorized official
DR. SARA M SHANE PSY.D. (EXECUTIVE DIRECTOR)
(215) 890-6289
Entity
Organization
Contact information
Practice address
1021 SOUTH 21ST STREET, PHILADELPHIA, PA 19146
(215) 735-5979
Mailing address
1021 S 21ST ST, PHILADELPHIA, PA 19146-2634
(215) 890-6277
(215) 790-9947
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
251K00000X
Public Health or Welfare Agency
Primary
820023
PA
Other
Enumeration date
10/03/2006
Last updated
01/07/2026
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