MEDICARE: MRS. WENDY D. RASNICK 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	CW018528	PA

General Provider Information

NPI Number	:	1730576802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WENDY D. RASNICK LCSW

Provider Business Mailing Address
First Line	:	536 HOFFMAN DR
Second Line	:
City	:	BRYN MAWR
State	:	PA
Zip	:	19010-1745
Country	:	US
Telephone Number	:	484-476-7510
Fax Number	:	484-450-0090

Provider Business Practice Location Address
First Line	:	1120 W TOWNSHIP LINE RD
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-4930
Country	:	US
Telephone Number	:	484-640-5552
Fax Number	:

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

Provider Enumeration Date	:	04/16/2015
Last Update Date	:	01/08/2024

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