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NPI Code Detail

MEDICARE: JESSICA T. ALSIS LCSW

MEDICARE: JESSICA T. ALSIS 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
1103K00000XBehavior Analyst
2104100000XSocial Worker
31041C0700XClinical Social WorkerCW000000PA

General Provider Information

NPI Number : 1518344399
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA T. ALSIS LCSW
Provider Business Mailing Address
First Line : 47 N NEW ARDMORE AVE
Second Line :
City : BROOMALL
State : PA
Zip : 19008-3019
Country : US
Telephone Number : 484-450-6476
Fax Number : 610-544-7142
Provider Business Practice Location Address
First Line : 390 REED RD FL 1
Second Line :
City : BROOMALL
State : PA
Zip : 19008-4008
Country : US
Telephone Number : 484-450-6476
Fax Number : 484-224-3398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2015
Last Update Date : 05/10/2018

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Directions to “ JESSICA T. ALSIS LCSW” Practice Location

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