Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | CW019026 | PA |
NPI | 1003260779 |
---|---|
Provider Name | Denis Michael Carey |
First Address | Philadelphia, PA 19103-6210 |
Second Address | Philadelphia, PA 19139-2922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 09/09/2020 |