Organization
CENTER FOR RACIAL & HEALTH EQUITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE JANELLE GILL PHD, LPC (CHIEF EXECUTIVE OFFICER)
(484) 362-0105
Entity
Organization
Contact information
Practice address
1100 S BROAD ST UNIT 5A, PHILADELPHIA, PA 19146-5059
(484) 362-0105
(484) 362-0105
Mailing address
200 BARR HARBOR DR STE 400, CONSHOHOCKEN, PA 19428-2978
(484) 362-0105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
101YS0200X
School Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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