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NPI Code Detail

MEDICARE: ASHLYN CANCELLIERI

MEDICARE: ASHLYN CANCELLIERI
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
1104100000XSocial WorkerSW141642PA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1679001648
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLYN CANCELLIERI
Provider Business Mailing Address
First Line : 1919 COTTMAN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-3816
Country : US
Telephone Number : 215-728-4600
Fax Number : 215-745-6511
Provider Business Practice Location Address
First Line : 1919 COTTMAN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-3816
Country : US
Telephone Number : 215-728-4600
Fax Number : 215-745-6511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2017
Last Update Date : 11/25/2024

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Directions to “ ASHLYN CANCELLIERI ” Practice Location

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