MEDICARE: GEORGE TIMBERS 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	CW018175	PA

General Provider Information

NPI Number	:	1487600789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE TIMBERS LCSW

Provider Business Mailing Address
First Line	:	1401 S 31ST ST
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-3506
Country	:	US
Telephone Number	:	215-925-2400
Fax Number	:	215-925-9162

Provider Business Practice Location Address
First Line	:	1401 S 4TH ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19147-5907
Country	:	US
Telephone Number	:	215-339-1079
Fax Number	:	215-339-1080

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	04/06/2017

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Directions to “ GEORGE TIMBERS LCSW” Practice Location

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