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DRUG & ALCOHOL OUTPATIENT
NPI 1376990366
Clinic/Center in Chester, PA

Active since May 19, 2016
301 W 15TH ST, CHESTER, PA 19013(610) 619-8600 Get Directions Write a Review

NPPES record last updated: January 15, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 15, 2021, Mar 18, 2019, Feb 13, 2019 and 1 more (4 updates tracked since 2016).

About Drug & Alcohol Outpatient NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DRUG & ALCOHOL OUTPATIENT (NPI 1376990366) is a healthcare organization registered as a clinic/center in Chester, Pennsylvania and active in the NPI registry since May 2016. The organization maintains a secondary practice location in Chester and lists Robert Jon Elders, Secretary, as its authorized official.

NPPES Registry Identity

NPI1376990366
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePROSPECT CCMC, LLC
Location Address301 W 15TH STChester, PA 19013
Mailing Address301 W 15th StChester, PA 19013-5300 · (610) 619-8600
Phone(610) 619-8600
Organization SubpartNo
Authorized OfficialRobert Jon EldersSecretary · (714) 788-1249
Enumeration DateMay 19, 2016
Last NPPES UpdateJanuary 15, 20214 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2021
✔ NPI 1376990366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
301 W 15TH ST, Chester, PA 19013
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Other Names 1

Other NameDrug & Alcohol Outpatient

Secondary Practice Location 1

Location 1310 W 15th StChester, PA 19013-5316 · Phone (610) 447-2040 · Fax (610) 447-6620

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIKA PILEGGI
Counselor (Addiction (Substance Use Disorder))
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8600
MALIK MUNDREY BA
Case Manager/Care Coordinator
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8600
CASSANDRA KATHRYN WAYSON GERGELY
Counselor (Mental Health)
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8799
MILTON MYERS
Case Management
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8600
CAILIN ELIZABETH SHALLOW
Case Manager/Care Coordinator
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8700
EMILY ANN PIZARRO
Case Manager/Care Coordinator
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8769
VIVIAN TYLER AMFT
Counselor (Mental Health)
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8741
BRIANA MONET BOOKHARD
Case Manager/Care Coordinator
301 W 15TH ST
CHESTER, PA 19013
Delaware County (610) 619-8774

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prospect Ccmc, LLC's NPI number?

The NPI number for Prospect Ccmc, LLC is 1376990366. It was assigned to this organization in the NPPES registry on May 19, 2016. The provider is also known as Drug & Alcohol Outpatient.

Where is Prospect Ccmc, LLC located?

Prospect Ccmc, LLC is located at 301 W 15th St, Chester, PA 19013. The listed phone number is (610) 619-8600.

What is Prospect Ccmc, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Prospect Ccmc, LLC was last updated on January 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.