MEDICARE: MS. ERICA SOBEL 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	1041C0700X	Clinical Social Worker	CW016309	PA

General Provider Information

NPI Number	:	1457587537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERICA SOBEL LCSW

Provider Business Mailing Address
First Line	:	2001 HAMILTON ST
Second Line	:	APT 403
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-4201
Country	:	US
Telephone Number	:	917-519-8351
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 HAMILTON ST
Second Line	:	APT 403
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-4201
Country	:	US
Telephone Number	:	917-519-8351
Fax Number	:

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

Provider Enumeration Date	:	06/03/2009
Last Update Date	:	06/16/2009

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