Healthcare Provider Details

I. General information

NPI: 1164435848
Provider Name (Legal Business Name): CYNTHIA ANN OKORE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5543 WINDSOR AVE
PHILADELPHIA PA
19143-4732
US

IV. Provider business mailing address

5543 WINDSOR AVE
PHILADELPHIA PA
19143-4724
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-5800
  • Fax: 215-823-4040
Mailing address:
  • Phone: 215-823-5800
  • Fax: 215-823-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013280
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: