Provider Demographics
NPI:1710356068
Name:GADSDEN, MALIK RAHSAAN (MHS)
Entity type:Individual
Prefix:MR
First Name:MALIK
Middle Name:RAHSAAN
Last Name:GADSDEN
Suffix:
Gender:M
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 SPRINGFIELD AVE
Mailing Address - Street 2:UNIT #5
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3514
Mailing Address - Country:US
Mailing Address - Phone:267-987-4098
Mailing Address - Fax:
Practice Address - Street 1:4715 SPRINGFIELD AVE
Practice Address - Street 2:UNIT #5
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-3514
Practice Address - Country:US
Practice Address - Phone:267-987-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health