MEDICARE: FRANCINE ALBERT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1041CO700X	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0724763000	OTHER		P.CHOICE
2	0724763000	OTHER		KEYSTONE
3	072476300	OTHER	PA	IND.BLUE,PERSONAL CHOICE,

General Provider Information

NPI Number	:	1023297116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCINE ALBERT LCSW

Provider Business Mailing Address
First Line	:	1915 RICHARD RD
Second Line	:
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-1621
Country	:	US
Telephone Number	:	215-657-8873
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 RICHARD RD
Second Line	:
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-1621
Country	:	US
Telephone Number	:	215-657-8873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	10/25/2007

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