MEDICARE: YASMIN CARTER LSW

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	104100000X	Social Worker	SW138477	PA

General Provider Information

NPI Number	:	1104592500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASMIN CARTER LSW

Provider Business Mailing Address
First Line	:	6900 SYLVESTER ST FL 1
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19149-1821
Country	:	US
Telephone Number	:	267-439-0162
Fax Number	:

Provider Business Practice Location Address
First Line	:	6900 SYLVESTER ST FL 1
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19149-1821
Country	:	US
Telephone Number	:	267-439-0162
Fax Number	:

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

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	08/17/2021

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Directions to “ YASMIN CARTER LSW” Practice Location

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