# THOMAS JEFFERSON UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THOMAS JEFFERSON UNIVERSITY
- **Other names:** Thomas Jefferson University Drug and Alcohol Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467547968
- **Legal business name:** THOMAS JEFFERSON UNIVERSITY
- **Authorized official:** DR. SARA M SHANE PSY.D. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (215) 890-6289

## Contact information

- **Practice address:** 1021 SOUTH 21ST STREET, PHILADELPHIA, PA 19146
- **Practice address phone:** (215) 735-5979
- **Mailing address:** 1021 S 21ST ST, PHILADELPHIA, PA 19146-2634
- **Mailing address phone:** (215) 890-6277
- **Mailing address fax:** (215) 790-9947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 251K00000X | Public Health or Welfare Agency | 820023 | PA | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 01/07/2026