Provider Demographics
NPI:1326878992
Name:2411 YORK HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:2411 YORK HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, CCMHC
Authorized Official - Phone:267-702-4537
Mailing Address - Street 1:6632 DITMAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-2715
Mailing Address - Country:US
Mailing Address - Phone:267-702-4537
Mailing Address - Fax:888-518-1609
Practice Address - Street 1:133 HEATHER RD STE 206
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3009
Practice Address - Country:US
Practice Address - Phone:267-702-4537
Practice Address - Fax:888-518-1609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty