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PROSPECT CCMC, LLC
NPI 1477113249
Clinic/Center in Collingdale, PA

Active since June 14, 2019
800 MACDADE BLVD, COLLINGDALE, PA 19023(610) 915-3496 Get Directions Write a Review

NPPES record last updated: January 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 15, 2021, Jun 14, 2019 (2 updates tracked since 2019).

About Prospect Ccmc, Llc NPPES

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

PROSPECT CCMC, LLC (NPI 1477113249) is a healthcare organization registered as a clinic/center in Collingdale, Pennsylvania and active in the NPI registry since June 2019. The organization lists Robert Jon Elders, Secretary, as its authorized official.

NPPES Registry Identity

NPI1477113249
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePROSPECT CCMC, LLC
Location Address800 MACDADE BLVDCollingdale, PA 19023-3826
Mailing Address800 Macdade BlvdCollingdale, PA 19023-3826 · (610) 915-3496
Phone(610) 915-3496
Organization SubpartNo
Authorized OfficialRobert Jon EldersSecretary · (714) 788-1249
Enumeration DateJune 14, 2019
Last NPPES UpdateJanuary 15, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2021
✔ NPI 1477113249 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).
800 MACDADE BLVD, Collingdale, PA 19023
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Other Names 1

Former Legal Business NameProspect Ccmc, Llc

Other Providers at the Same Location NPPES 15

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

KIMBERLY GRUDEN LSW
Social Worker
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 938-9380
JEFFANE BERNARDIN
Counselor (Mental Health)
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 522-4300
CROZER-CHESTER MEDICAL CENTER
Clinic/Center
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 447-2000
MELISSA MCKEOWN MSW
Social Worker (School)
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 938-9000
JESSICA HAYDEN
Social Worker (School)
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 938-9372
MS. SIMONE ROBIN GILLIS MSMHC
Counselor (Mental Health)
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 938-9381
RAVEN BUCHANAN M.S.W.
Counselor (School)
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 938-9379
MR. FRANCIS T BLAMOH JR.
Counselor (Mental Health)
800 MACDADE BLVD
COLLINGDALE, PA 19023
Delaware County (610) 938-9373

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 1477113249. It was assigned to this organization in the NPPES registry on June 14, 2019.

Where is Prospect Ccmc, LLC located?

Prospect Ccmc, LLC is located at 800 Macdade Blvd, Collingdale, PA 19023. The listed phone number is (610) 915-3496.

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.