Provider Demographics
NPI:1063291367
Name:KYRA SJARIF LLC
Entity type:Organization
Organization Name:KYRA SJARIF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SJARIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-371-3073
Mailing Address - Street 1:709 S MARVINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 SOUTH 17TH STREET
Practice Address - Street 2:SUITE 2121
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103
Practice Address - Country:US
Practice Address - Phone:510-371-3073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty