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General NPI Number Information
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NPI Number | 1497294045
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Entity Type | Individual
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Provider Name | SAMMY CHEBOLIO LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 503 WASHINGTON AVE STE 1A
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City | NEWTOWN
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State | PA
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Zip | 18940-2153
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Country | US
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Telephone | 215-390-1941
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Fax |
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Provider Business Mailing Address
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Address Line | 112 BORDER ROCK RD
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City | LEVITTOWN
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State | PA
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Zip | 19057-3054
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Country | US
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Telephone | 215-390-1941
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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 | SW130259
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License Number State | PA
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