Healthcare Provider Details

I. General information

NPI: 1053886598
Provider Name (Legal Business Name): PATRICIA LAMANA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 THOMAS JONES WAY STE 204
EXTON PA
19341-2553
US

IV. Provider business mailing address

495 THOMAS JONES WAY STE 204
EXTON PA
19341-2553
US

V. Phone/Fax

Practice location:
  • Phone: 892-380-0610
  • Fax:
Mailing address:
  • Phone: 380-061-0892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number37663
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW023084
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: