=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356970024
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RIVKA VOLOVIK LSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/05/2020
-----------------------------------------------------
Last Update Date | 04/05/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1301 SPRINGDALE RD STE 150
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08003-2763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-648-5907
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 606 COOPER LANDING RD APT A2B
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08002-1709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-648-5907
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 44SL06541400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------