MEDICARE: MR. FRANCIS JOHN GUARNACCIA MSW - 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	104100000X	Social Worker	NY028180R	NY
2	1041C0700X	Clinical Social Worker	PACW000937L	PA
3	1041C0700X	Clinical Social Worker	PA-CW-000937-L	PA

General Provider Information

NPI Number	:	1164463170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANCIS JOHN GUARNACCIA MSW - LCSW

Provider Business Mailing Address
First Line	:	255 SOUTH 17TH STREET
Second Line	:	SUITE 1509
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-2813
Country	:	US
Telephone Number	:	215-790-1071
Fax Number	:	215-545-5384

Provider Business Practice Location Address
First Line	:	255 SOUTH 17TH STREET
Second Line	:	SUITE 1509
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-2813
Country	:	US
Telephone Number	:	215-790-1071
Fax Number	:	215-545-5384

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	07/01/2011

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