Healthcare Provider Details

I. General information

NPI: 1134610843
Provider Name (Legal Business Name): ALKANEASE GARRETT M.ED, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 ARAMINGO AVE STE 5C
PHILADELPHIA PA
19134-4607
US

IV. Provider business mailing address

PO BOX 746722
ATLANTA GA
30374-6722
US

V. Phone/Fax

Practice location:
  • Phone: 215-444-7472
  • Fax:
Mailing address:
  • Phone: 127-339-7303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW132846
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: