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General NPI Number Information
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NPI Number | 1801394267
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Entity Type | Individual
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Provider Name | EVELYN JONES BUSBY LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 595 BETHLEHEM PIKE
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City | MONTGOMERYVILLE
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State | PA
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Zip | 18936-9710
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Country | US
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Telephone | 215-630-0444
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Fax | 215-630-0444
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Provider Business Mailing Address
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Address Line | 1210 BRIDGETOWN PIKE
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City | FEASTERVILLE TREVOSE
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State | PA
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Zip | 19053-2219
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Country | US
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Telephone | 215-630-0444
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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 | CW013539
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License Number State | PA
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