MEDICARE: NADIA AWAIS LPC, LCADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	37LC00202600	NJ
2	101YP2500X	Professional Counselor	37PC00465700	NJ
3	101YP2500X	Professional Counselor	PC010487	PA

General Provider Information

NPI Number	:	1699169425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA AWAIS LPC, LCADC

Provider Business Mailing Address
First Line	:	2326 GREENWICH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-4109
Country	:	US
Telephone Number	:	732-853-5705
Fax Number	:

Provider Business Practice Location Address
First Line	:	2326 GREENWICH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-4109
Country	:	US
Telephone Number	:	732-853-5705
Fax Number	:

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

Provider Enumeration Date	:	03/18/2015
Last Update Date	:	01/26/2022

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