Healthcare Provider Details

I. General information

NPI: 1427535764
Provider Name (Legal Business Name): CHRISTINA ANNE KULP LCSW, ACHP-SW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 12/24/2021
Certification Date: 12/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7815 CORNING RD
ZIONSVILLE PA
18092-2322
US

IV. Provider business mailing address

7815 CORNING RD
ZIONSVILLE PA
18092-2322
US

V. Phone/Fax

Practice location:
  • Phone: 610-972-1473
  • Fax:
Mailing address:
  • Phone: 610-972-1473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018421
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: