Organization
PHILADELPHIA SCHOOL OF PSYCHOANALYSIS
Active
Other names
Philadelphia Consulation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA CORREALE LCSW, NCPSYA (EXECUTIVE DIRECTOR)
(215) 732-8244
Entity
Organization
Contact information
Practice address
313 S 16TH ST, PHILADELPHIA, PA 19102-4908
(215) 732-8244
(215) 732-8454
Mailing address
313 S 16TH ST, PHILADELPHIA, PA 19102-4908
(215) 732-8244
(215) 732-8454
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TH0004X
Health Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
122030
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007645820002
—
PA
Enumeration date
12/21/2006
Last updated
10/09/2017
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