| Tara Devineni Lcsw Llc | |
|
1137 Lancaster Ave Berwyn PA 19312-1243 | |
| (484) 424-7218 | |
| Not Available |
| Full Name | Tara Devineni Lcsw Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1137 Lancaster Ave, Berwyn, Pennsylvania |
| Authorized Official Name and Position | Tara Devineni (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4844247218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Devineni Lcsw Llc 1137 Lancaster Ave Berwyn PA 19312-1243 Ph: (484) 424-7218 | Tara Devineni Lcsw Llc 1137 Lancaster Ave Berwyn PA 19312-1243 Ph: (484) 424-7218 |
| NPI Number | 1871008706 |
|---|---|
| Provider Enumeration Date | 12/14/2017 |
| Last Update Date | 12/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871008706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | CW019653 (Pennsylvania) | Primary |
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