Provider Demographics
NPI:1104370311
Name:ROSENBLUM, JODY (LCSW)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:ROSENBLUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3546
Mailing Address - Country:US
Mailing Address - Phone:267-337-2334
Mailing Address - Fax:
Practice Address - Street 1:11 WELDON DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2359
Practice Address - Country:US
Practice Address - Phone:215-345-8530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0189471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical