MEDICARE: DR. ROSEANNA MCCLEARY MSW, PHD, LCSW, ACSW

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	CW020832	PA

General Provider Information

NPI Number	:	1740826429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSEANNA MCCLEARY MSW, PHD, LCSW, ACSW

Provider Business Mailing Address
First Line	:	8108 FENTON RD
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-7142
Country	:	US
Telephone Number	:	661-204-4066
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 STENTON AVE STE 1F
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-3260
Country	:	US
Telephone Number	:	215-247-5400
Fax Number	:

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

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	11/18/2019

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