| The Consortium, Inc. | |
|
451 S University Ave Philadelphia PA 19104-4544 | |
| (215) 596-8100 | |
| (215) 382-4405 |
| Full Name | The Consortium, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 451 S University Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John F White (PRESIDENT/CEO) |
| Authorized Official Contact | 2155968100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Consortium, Inc. 3751 Island Ave Ste 303 Philadelphia PA 19153-3237 Ph: (215) 596-8100 | The Consortium, Inc. 451 S University Ave Philadelphia PA 19104-4544 Ph: (215) 596-8100 |
| NPI Number | 1194757989 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 12/22/2020 |
| Certification Date | 12/22/2020 |
| Medicare PECOS PAC ID | 9638072580 |
|---|---|
| Medicare Enrollment ID | O20040129000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194757989 | NPI | - | NPPES |
| 100715523 0001 | Medicaid | PA |
| Provider Name | Alice G Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811044373 PECOS PAC ID: 6507889961 Enrollment ID: I20060111000932 |
| Provider Name | Chinyere Ndubizu Achi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164533469 PECOS PAC ID: 2163493560 Enrollment ID: I20061221000041 |
| Provider Name | Kavita Bharwani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295869329 PECOS PAC ID: 1254221575 Enrollment ID: I20080821000485 |
| Provider Name | Kathleen A K Kline |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831286988 PECOS PAC ID: 1052219748 Enrollment ID: I20100917000037 |
| Provider Name | Michele L Chubb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902919632 PECOS PAC ID: 4981896446 Enrollment ID: I20101004000370 |
| Provider Name | Walter E Bantom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194741710 PECOS PAC ID: 3779771407 Enrollment ID: I20101222000689 |
| Provider Name | Courtney Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790979490 PECOS PAC ID: 9133398506 Enrollment ID: I20110802000237 |
| Provider Name | Bernard Amiel Harris |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1619081726 PECOS PAC ID: 0345419156 Enrollment ID: I20110812000317 |
| Provider Name | Sarah E Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790945848 PECOS PAC ID: 2567620339 Enrollment ID: I20120224000331 |
| Provider Name | Paul M Schaefer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942460878 PECOS PAC ID: 9537324348 Enrollment ID: I20120629000008 |
| Provider Name | Cynthia J Corbin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043629868 PECOS PAC ID: 6002131695 Enrollment ID: I20150202000586 |
| Provider Name | Carter Cloyd |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073702536 PECOS PAC ID: 3870819337 Enrollment ID: I20150302000089 |
| Provider Name | Michael Dean Kaltenbach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972770758 PECOS PAC ID: 9537485966 Enrollment ID: I20150303000748 |
| Provider Name | Rena D Linden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265081780 PECOS PAC ID: 6103250626 Enrollment ID: I20191216002177 |
| Provider Name | Fitz Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972142669 PECOS PAC ID: 4486084167 Enrollment ID: I20200421000331 |
| Provider Name | Susan Charlotte Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740821222 PECOS PAC ID: 3476963950 Enrollment ID: I20201112001190 |
| Provider Name | Diana Cozma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578860672 PECOS PAC ID: 4284032376 Enrollment ID: I20211004001835 |
| Provider Name | Valerie Margaret King Ernst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952311565 PECOS PAC ID: 6305840158 Enrollment ID: I20220309000817 |
| Provider Name | Andrew Hogrogian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609360684 PECOS PAC ID: 6103172374 Enrollment ID: I20220804002279 |
| Provider Name | Brooke Marie Beehler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093008559 PECOS PAC ID: 4385950054 Enrollment ID: I20220922001887 |
| Provider Name | Sharon Lawerence Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093856882 PECOS PAC ID: 6103724653 Enrollment ID: I20240210000182 |
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