Provider Demographics
NPI:1972319911
Name:SAM SPERLING LLC
Entity type:Organization
Organization Name:SAM SPERLING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:SPERLING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:267-754-2660
Mailing Address - Street 1:4513 MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-3317
Mailing Address - Country:US
Mailing Address - Phone:267-754-2660
Mailing Address - Fax:267-200-2069
Practice Address - Street 1:4513 MITCHELL ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-3317
Practice Address - Country:US
Practice Address - Phone:267-754-2660
Practice Address - Fax:267-200-2069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)