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Organization

A NEW SPIRIT BEHAVIORAL HEALTH SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DENISE RAY-SHIELDS PHD (OWNER/THERAPIST)
(610) 772-3939
Entity
Organization

Contact information

Practice address
111 PRESIDENTIAL BLVD LBBY SUITE237, BALA CYNWYD, PA 19004-1008
(610) 772-3939
(215) 877-3529
Mailing address
5745 WOODBINE AVE, PHILADELPHIA, PA 19131-1236
(215) 983-1488
(215) 877-3529

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW005909E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000236440
OPTUM
PA
Enumeration date
04/09/2018
Last updated
04/09/2018
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