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General NPI Number Information
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NPI Number | 1770715732
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Entity Type | Individual
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Provider Name | KELLY MARIE SCHIAVONE LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 01/12/2020
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Provider Practice Location Address
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Address Line | 602 S BETHLEHEM PIKE STE B
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City | AMBLER
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State | PA
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Zip | 19002-5809
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Country | US
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Telephone | 215-279-0983
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Fax |
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Provider Business Mailing Address
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Address Line | 13 COTTONWOOD RD
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City | SWEDESBORO
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State | NJ
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Zip | 08085-3183
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Country | US
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Telephone | 215-279-0983
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05845300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW016081
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License Number State | PA
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