| Ali Wilburn Lcsw Llc | |
|
5 Mystic Ln Malvern PA 19355-1942 | |
| (610) 716-3979 | |
| Not Available |
| Full Name | Ali Wilburn Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5 Mystic Ln, Malvern, Pennsylvania |
| Authorized Official Name and Position | Alexis True Wilburn (PSYCHOTHERAPIST) |
| Authorized Official Contact | 6107163979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ali Wilburn Lcsw Llc 5 Mystic Ln Malvern PA 19355-1942 Ph: (610) 716-3979 | Ali Wilburn Lcsw Llc 5 Mystic Ln Malvern PA 19355-1942 Ph: (610) 716-3979 |
| NPI Number | 1609256973 |
|---|---|
| Provider Enumeration Date | 06/02/2015 |
| Last Update Date | 06/02/2015 |
| Medicare PECOS PAC ID | 7113230483 |
|---|---|
| Medicare Enrollment ID | O20150715000992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609256973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CW015351 (Pennsylvania) | Primary |
| Provider Name | Alexis True Wilburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093865602 PECOS PAC ID: 8022321397 Enrollment ID: I20150715001218 |
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