Healthcare Provider Details

I. General information

NPI: 1508843459
Provider Name (Legal Business Name): JANINE M. STOFFEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5675 N FRONT ST
PHILADELPHIA PA
19120-2719
US

IV. Provider business mailing address

1500 MARKET STREET LM 500 WEST TOWER
PHILADELPHIA PA
19120-2100
US

V. Phone/Fax

Practice location:
  • Phone: 215-279-9666
  • Fax: 215-279-9674
Mailing address:
  • Phone: 215-985-2595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW009084L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: