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NPI Code Detail

MEDICARE: MS. NADINE JILL CARPENTER M.A., LCSW

MEDICARE: MS. NADINE JILL CARPENTER M.A., 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 WorkerCW014401PA

General Provider Information

NPI Number : 1174512610
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NADINE JILL CARPENTER M.A., LCSW
Provider Business Mailing Address
First Line : 3202 HARTFORD CT
Second Line :
City : NEWTOWN SQUARE
State : PA
Zip : 19073-1069
Country : US
Telephone Number : 610-742-7725
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BLACKHORSE HILL RD
Second Line :
City : COATESVILLE
State : PA
Zip : 19320-2040
Country : US
Telephone Number : 610-384-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 02/10/2022

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