MEDICARE: DAMALI NAJUMA STANSBURY LMSW

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	104100000X	Social Worker	44SL06691200	NJ
2	104100000X	Social Worker	SW138522	PA
3	104100000X	Social Worker	116009	NY

General Provider Information

NPI Number	:	1649900119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAMALI NAJUMA STANSBURY LMSW

Provider Business Mailing Address
First Line	:	PO BOX 20129
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-0429
Country	:	US
Telephone Number	:	267-978-2072
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 W OREGON AVE # 20129
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-4197
Country	:	US
Telephone Number	:	215-978-2072
Fax Number	:

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

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	06/02/2026

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