Healthcare Provider Details

I. General information

NPI: 1871667626
Provider Name (Legal Business Name): SHIRLEY LOUISE ZAGORSKI MSW, LCSW, QCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHIRLEY LOUISE SMITH

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 N CHARLOTTE ST STE 1D
POTTSTOWN PA
19464-3974
US

IV. Provider business mailing address

933 N CHARLOTTE ST STE 1D
POTTSTOWN PA
19464-3974
US

V. Phone/Fax

Practice location:
  • Phone: 610-323-4673
  • Fax: 610-323-4672
Mailing address:
  • Phone: 610-323-4673
  • Fax: 610-323-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013084
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: