=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821291170
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICIA R FUREY LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1501 N CEDAR CREST BLVD SUITE 101
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-437-4656
-----------------------------------------------------
Fax | 610-435-3606
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4695 SWEETBRIAR CIRCLE
-----------------------------------------------------
City | EMMAUS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-967-9668
-----------------------------------------------------
Fax | 610-435-3606
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CW013964
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------