Healthcare Provider Details

I. General information

NPI: 1871061523
Provider Name (Legal Business Name): JAMIE ELIZABETH PLOFSKY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2018
Last Update Date: 12/23/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CHESTNUT ST STE 2
PHILADELPHIA PA
19102-2700
US

IV. Provider business mailing address

1500 CHESTNUT ST STE 2
PHILADELPHIA PA
19102-2700
US

V. Phone/Fax

Practice location:
  • Phone: 215-910-4852
  • Fax:
Mailing address:
  • Phone: 215-910-4852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number085713
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06002500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW021396
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: