Organization
MAINLINE MENTAL HEALTH, WELLNESS & RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUMA MAHMOOD DO (MEDICAL DIRECTOR)
(724) 374-8626
Entity
Organization
Contact information
Practice address
111 FORREST AVE FL 2, NARBERTH, PA 19072-2252
(724) 374-8626
(888) 598-7517
Mailing address
2300 WALNUT ST APT 714, PHILADELPHIA, PA 19103-5547
(888) 598-7517
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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