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NPI Code Detail

MEDICARE: MRS. MARYANN ELIZABETH ADAMS LCSW

MEDICARE: MRS. MARYANN ELIZABETH ADAMS 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
11041C0700XClinical Social WorkerCW002364LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10475447000OTHERPAMHS FOR INDEPENDENCE BLUE
27091513OTHERPAAETNA

General Provider Information

NPI Number : 1891722104
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARYANN ELIZABETH ADAMS LCSW
Provider Business Mailing Address
First Line : 8127 ELBERON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-1812
Country : US
Telephone Number : 215-945-2550
Fax Number : 215-945-3595
Provider Business Practice Location Address
First Line : 100 LEVITTOWN PKWY
Second Line :
City : LEVITTOWN
State : PA
Zip : 19054-3502
Country : US
Telephone Number : 215-945-2550
Fax Number : 215-945-3595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 07/08/2007

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