MEDICARE: GAIL CUMMINGS LEVAN L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW015732	PA

General Provider Information

NPI Number	:	1053657858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL CUMMINGS LEVAN L.C.S.W.

Provider Business Mailing Address
First Line	:	2318 GREEN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3121
Country	:	US
Telephone Number	:	215-260-4881
Fax Number	:

Provider Business Practice Location Address
First Line	:	2318 GREEN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3121
Country	:	US
Telephone Number	:	215-260-4881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/25/2012
Last Update Date	:	12/25/2012

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Directions to “ GAIL CUMMINGS LEVAN L.C.S.W.” Practice Location

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