MEDICARE: MS. ARLENE P JONES TIPPETT MSW

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	CW013170	PA

General Provider Information

NPI Number	:	1346575487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ARLENE P JONES TIPPETT MSW

Provider Business Mailing Address
First Line	:	PO BOX 406
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-0406
Country	:	US
Telephone Number	:	610-844-4782
Fax Number	:	610-941-5624

Provider Business Practice Location Address
First Line	:	111 PRESIDENTIAL BLVD
Second Line	:	SUITE 237
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-1008
Country	:	US
Telephone Number	:	610-844-4782
Fax Number	:	610-941-5624

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

Provider Enumeration Date	:	10/07/2009
Last Update Date	:	03/03/2011

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