Prospect Ccmc, LLC
Prospect Ccmc, LLC is a healthcare organization registered as Clinic/Center in Collingdale, PA, holding Type 2 (organization) NPI 1477113249 since 2019. The authorized official on file is Robert Elders, Secretary.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1477113249 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Prospect Ccmc, LLC |
| Other name | <Unavail> |
| Practice address | 800 MACDADE BLVD, Collingdale, PA, 19023 |
| Phone | 6109153496 |
| Enumeration date | 2019-06-14 |
| Last updated in NPPES | 2021-01-15 |
Authorized official
| Name | Robert Elders |
|---|---|
| Title | Secretary |
| Phone | 7147881249 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Prospect Ccmc, LLC NPI: 1477113249 Taxonomy: 261Q00000X (Clinic/Center) Address: 800 MACDADE BLVD, Collingdale, PA, 19023
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1023177987 | Kimberly Gruden | Individual | Social Worker | Collingdale, PA |
| 1215073507 | Crozer-Chester Medical Center | Organization | Clinic/Center | Collingdale, PA |
| 1740435791 | Nicole Lewis | Individual | School Social Worker | Collingdale, PA |
| 1801121793 | Patrica Sullivan | Individual | Social Worker | Collingdale, PA |
| 1922379197 | Jacqueline Litz | Individual | Social Worker | Collingdale, PA |
| 1427329432 | Simone Gillis | Individual | Mental Health Counselor | Collingdale, PA |
| 1487091732 | Francis Blamoh | Individual | Mental Health Counselor | Collingdale, PA |
| 1396170874 | Jessica Hayden | Individual | School Social Worker | Collingdale, PA |
Verify this record
Cross-check NPI 1477113249 against the authoritative CMS record: view Prospect Ccmc, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Prospect Ccmc, LLC?
What is the NPI number for Prospect Ccmc, LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2021-01-15.