Healthcare Provider Details

I. General information

NPI: 1801129648
Provider Name (Legal Business Name): HILDEGARDE VIRGINIA BALEK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 09/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5085 GAYMAN RD
DOYLESTOWN PA
18902-9011
US

IV. Provider business mailing address

5085 GAYMAN RD
DOYLESTOWN PA
18902-9011
US

V. Phone/Fax

Practice location:
  • Phone: 215-489-1186
  • Fax:
Mailing address:
  • Phone: 215-489-1186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCWO13506
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: