NPI 1508369141 · live from the CMS NPI Registry
Nicollette Rose Airhart, LCSW
Social Worker, Clinical in Philadelphia, PA. National Provider Identifier 1508369141, active.
NPI record
| NPI | 1508369141 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 1819 John F Kennedy Blvd Ste 302, Philadelphia, PA 19103 |
| Practice phone | 330-495-8763 |
| Mailing address | 2686 Tilton St, Philadelphia, PA 19125 |
| Enumerated | March 9, 2018 |
| Last updated | March 9, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | CW019852 (PA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.