Healthcare Provider Details

I. General information

NPI: 1063541068
Provider Name (Legal Business Name): EVELYN RUTH SACHS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS EVELYN RUTH HUTTON

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 ARCH STREET 5TH FLOOR
PHILADELPHIA PA
19103
US

IV. Provider business mailing address

236 PHILIP PLACE
PHILADELPHIA PA
19106
US

V. Phone/Fax

Practice location:
  • Phone: 215-496-9700
  • Fax:
Mailing address:
  • Phone: 215-922-4682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: