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NPI Code Detail

MEDICARE: DANIELLA ALCIN LIBERTINO LCSW

MEDICARE:   DANIELLA ALCIN LIBERTINO  LCSW
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
11041C0700XClinical Social WorkerCW018893PA

General Provider Information

NPI Number : 1396103792
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLA ALCIN LIBERTINO LCSW
Provider Business Mailing Address
First Line : 1924 WAVERLY ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146-1425
Country : US
Telephone Number : 646-409-8086
Fax Number :
Provider Business Practice Location Address
First Line : 1924 WAVERLY ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146-1425
Country : US
Telephone Number : 646-409-8086
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2016
Last Update Date : 01/18/2017

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Directions to “ DANIELLA ALCIN LIBERTINO LCSW” Practice Location

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