Healthcare Provider Details

I. General information

NPI: 1265007322
Provider Name (Legal Business Name): ANA LAURA GELMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S 17TH ST STE 1008
PHILADELPHIA PA
19103-6210
US

IV. Provider business mailing address

255 S 17TH ST STE 1008
PHILADELPHIA PA
19103-6210
US

V. Phone/Fax

Practice location:
  • Phone: 267-589-9834
  • Fax:
Mailing address:
  • Phone: 267-589-9834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW021843
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: