Healthcare Provider Details

I. General information

NPI: 1437813508
Provider Name (Legal Business Name): ELIZABETH CHANG MSS, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 POWELL ST STE 100
NORRISTOWN PA
19401-3358
US

IV. Provider business mailing address

PO BOX 789967
PHILADELPHIA PA
19178-9967
US

V. Phone/Fax

Practice location:
  • Phone: 484-622-7618
  • Fax: 610-270-0163
Mailing address:
  • Phone: 484-622-7395
  • Fax: 484-622-7399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW021582
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: