Provider Demographics
NPI:1861062044
Name:CENTER FOR ANXIETY, OCD, AND COGNITIVE BEHAVIORAL THERAPY, LLD.
Entity type:Organization
Organization Name:CENTER FOR ANXIETY, OCD, AND COGNITIVE BEHAVIORAL THERAPY, LLD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAZIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-741-4719
Mailing Address - Street 1:1518 WALNUT ST STE 1702
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3409
Mailing Address - Country:US
Mailing Address - Phone:267-577-0013
Mailing Address - Fax:
Practice Address - Street 1:1518 WALNUT ST STE 1702
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3409
Practice Address - Country:US
Practice Address - Phone:267-577-0013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2024-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)