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General NPI Number Information
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NPI Number | 1396147476
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Entity Type | Individual
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Provider Name | CARMEN MARIA MOEDANO PHD, MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/21/2014
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1601 WALNUT ST SUITE 1524
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2944
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Country | US
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Telephone | 267-282-1068
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 WALNUT ST SUITE 1524
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2944
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW131461
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License Number State | PA
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