Healthcare Provider Details

I. General information

NPI: 1053788307
Provider Name (Legal Business Name): JAN CAREY, LCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2015
Last Update Date: 08/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S MAIN ST SUITE 10
DOYLESTOWN PA
18901-4815
US

IV. Provider business mailing address

50 PAWNEE RD
NEW BRITAIN PA
18901-5141
US

V. Phone/Fax

Practice location:
  • Phone: 215-272-1161
  • Fax: 844-639-9659
Mailing address:
  • Phone: 215-272-1161
  • Fax: 844-639-9659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW015790
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. JAN TERESE CAREY
Title or Position: PSYCHOTHERSPIST/OWNER
Credential: LCSW
Phone: 215-272-1161