MEDICARE: DR. JEAN HENRY PH.D. M.S.S.

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	CW007233	PA

General Provider Information

NPI Number	:	1477710093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN HENRY PH.D. M.S.S.

Provider Business Mailing Address
First Line	:	220 W RITTENHOUSE SQ
Second Line	:	STE 11 A
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5737
Country	:	US
Telephone Number	:	215-731-9993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 WALNUT ST
Second Line	:	STE 1300
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5457
Country	:	US
Telephone Number	:	215-731-9993
Fax Number	:

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

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	05/21/2008

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