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NPI Code Detail

MEDICARE: DEBRA LYNN BENNETT LCSW

MEDICARE:   DEBRA LYNN BENNETT  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
11041C0700XClinical Social WorkerCW018360PA

General Provider Information

NPI Number : 1144008590
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA LYNN BENNETT LCSW
Provider Business Mailing Address
First Line : PO BOX 595
Second Line :
City : AUDUBON
State : NJ
Zip : 08106-0595
Country : US
Telephone Number : 203-824-6383
Fax Number :
Provider Business Practice Location Address
First Line : 1211 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-4103
Country : US
Telephone Number : 215-525-8657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2023
Last Update Date : 09/18/2023

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Directions to “ DEBRA LYNN BENNETT LCSW” Practice Location

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