MEDICARE: BETH F SOMMER MS, 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	CW-001082-L	PA

General Provider Information

NPI Number	:	1689768814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH F SOMMER MS, LCSW

Provider Business Mailing Address
First Line	:	7118 MCCALLUM ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-2935
Country	:	US
Telephone Number	:	215-242-4496
Fax Number	:	215-242-2075

Provider Business Practice Location Address
First Line	:	7118 MCCALLUM ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-2935
Country	:	US
Telephone Number	:	267-879-1477
Fax Number	:	215-242-2075

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/21/2022

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