MEDICARE: ASHLEY BREGMAN 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	CW020893	PA

General Provider Information

NPI Number	:	1962924399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY BREGMAN LCSW

Provider Business Mailing Address
First Line	:	45 W MOUNT AIRY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-2402
Country	:	US
Telephone Number	:	203-848-9366
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 W MOUNT AIRY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-2402
Country	:	US
Telephone Number	:	203-848-9366
Fax Number	:

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

Provider Enumeration Date	:	07/07/2017
Last Update Date	:	10/18/2021

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