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NPI 1902245905

NPI 1902245905 : GWENDOLYN K BLANKENSHIP LCSW : EPHRATA, PA

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General NPI Number Information
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    NPI Number           |    1902245905
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    Entity Type          |    Individual 
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    Provider Name        |    GWENDOLYN K BLANKENSHIP LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/24/2013
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    Last Update Date     |    05/28/2024
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Provider Practice Location Address
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    Address Line         |    344 N READING RD 
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    City                 |    EPHRATA
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    State                |    PA
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    Zip                  |    17522-1651
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    Country              |    US
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    Telephone            |    717-738-1125
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    Fax                  |    717-738-0606
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Provider Business Mailing Address
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    Address Line         |    601 MEMORY LN 
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    City                 |    YORK
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    State                |    PA
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    Zip                  |    17402-2231
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    Country              |    US
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    Telephone            |    717-851-1405
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    Fax                  |    717-851-6969
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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       |    0904004052
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    License Number State |    VA
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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       |    CW018315
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    License Number State |    PA
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