Provider Demographics
NPI:1144310830
Name:GEMMA SERVICES
Entity type:Organization
Organization Name:GEMMA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:EM
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-825-4440
Mailing Address - Street 1:512 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1001
Mailing Address - Country:US
Mailing Address - Phone:610-825-4440
Mailing Address - Fax:610-825-7989
Practice Address - Street 1:512 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1001
Practice Address - Country:US
Practice Address - Phone:610-825-4440
Practice Address - Fax:610-825-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3-00-46-405-0251300000X
PA139460251J00000X
251K00000X, 261QM0855X
PA122280251S00000X
PA140260261Q00000X
PA111280323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No251300000XAgenciesLocal Education Agency (LEA)
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007760280015Medicaid
PA1007760280022Medicaid
PA1007760280016Medicaid
PA1007760280003Medicaid
PA1007760280005Medicaid
PA1007760280005Medicaid