MEDICARE: CHRISTINA ANNE KULP LCSW, ACHP-SW

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	CW018421	PA

General Provider Information

NPI Number	:	1427535764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ANNE KULP LCSW, ACHP-SW

Provider Business Mailing Address
First Line	:	7815 CORNING RD
Second Line	:
City	:	ZIONSVILLE
State	:	PA
Zip	:	18092-2322
Country	:	US
Telephone Number	:	610-972-1473
Fax Number	:

Provider Business Practice Location Address
First Line	:	7815 CORNING RD
Second Line	:
City	:	ZIONSVILLE
State	:	PA
Zip	:	18092-2322
Country	:	US
Telephone Number	:	610-972-1473
Fax Number	:

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

Provider Enumeration Date	:	07/19/2018
Last Update Date	:	12/24/2021

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