Healthcare Provider Details

I. General information

NPI: 1427120088
Provider Name (Legal Business Name): WILLIAM JEFFREY GARSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 FLOURTOWN RD
PLYMOUTH MEETING PA
19462-1205
US

IV. Provider business mailing address

60 FLOURTOWN RD
PLYMOUTH MEETING PA
19462-1205
US

V. Phone/Fax

Practice location:
  • Phone: 215-450-4306
  • Fax: 610-525-1935
Mailing address:
  • Phone: 215-450-4306
  • Fax: 610-525-1935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014946
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: