MEDICARE: JULIA SPEVAK 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	CW020283	PA

General Provider Information

NPI Number	:	1790337301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA SPEVAK LCSW

Provider Business Mailing Address
First Line	:	9 CHERRY CT
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-2517
Country	:	US
Telephone Number	:	610-547-4068
Fax Number	:

Provider Business Practice Location Address
First Line	:	2935 BYBERRY RD STE 108
Second Line	:
City	:	HATBORO
State	:	PA
Zip	:	19040-2831
Country	:	US
Telephone Number	:	610-547-4068
Fax Number	:

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

Provider Enumeration Date	:	07/13/2019
Last Update Date	:	07/13/2019

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Directions to “ JULIA SPEVAK LCSW” Practice Location

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