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NPI Code Detail

MEDICARE: MS. MELANIE GRACE GERALD MSW, LCSW

MEDICARE: MS. MELANIE GRACE GERALD 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
1104100000XSocial Worker44SL05517000NJ
21041C0700XClinical Social WorkerCW018835PA

General Provider Information

NPI Number : 1396126991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELANIE GRACE GERALD MSW, LCSW
Provider Business Mailing Address
First Line : 37 CHERRY ST
Second Line :
City : MOUNT HOLLY
State : NJ
Zip : 08060-1834
Country : US
Telephone Number : 732-754-2990
Fax Number :
Provider Business Practice Location Address
First Line : 1800 JOHN F KENNEDY BLVD STE 1404
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-7417
Country : US
Telephone Number : 215-398-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2015
Last Update Date : 12/15/2021

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