Healthcare Provider Details

I. General information

NPI: 1437835964
Provider Name (Legal Business Name): CHANA FUCHS LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MONTGOMERY AVE APT 206
BALA CYNWYD PA
19004-2844
US

IV. Provider business mailing address

121 MONTGOMERY AVE APT 206
BALA CYNWYD PA
19004-2844
US

V. Phone/Fax

Practice location:
  • Phone: 301-219-1093
  • Fax:
Mailing address:
  • Phone: 301-219-1093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25519
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW024975
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: