NPI 1336657709 · live from the CMS NPI Registry
Eileen B Addis, LCSW
Social Worker, Clinical in Philadelphia, PA. National Provider Identifier 1336657709, active.
NPI record
| NPI | 1336657709 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 4100 Main St Ste 403, Philadelphia, PA 19127 |
| Practice phone | 215-487-3000 |
| Mailing address | 670 Mallard Rd, Wayne, PA 19087 |
| Enumerated | January 18, 2018 |
| Last updated | July 5, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | CW018387 (PA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.