Healthcare Provider Details

I. General information

NPI: 1174842199
Provider Name (Legal Business Name): ANJANA DESHPANDE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 N BETHLEHEM PIKE #203-B
SPRINGHOUSE PA
19477
US

IV. Provider business mailing address

881 PARKWOOD RD
BLUE BELL PA
19422-1242
US

V. Phone/Fax

Practice location:
  • Phone: 610-506-2861
  • Fax:
Mailing address:
  • Phone: 610-506-2861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018623
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: