Provider Demographics
NPI:1164463170
Name:GUARNACCIA, FRANCIS JOHN (MSW - LCSW)
Entity Type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:JOHN
Last Name:GUARNACCIA
Suffix:
Gender:M
Credentials:MSW - LCSW
Other - Prefix:MR
Other - First Name:FRANK
Other - Middle Name:JOHN
Other - Last Name:GUARNACCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:255 SOUTH 17TH STREET
Mailing Address - Street 2:SUITE 1509
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-2813
Mailing Address - Country:US
Mailing Address - Phone:215-790-1071
Mailing Address - Fax:215-545-5384
Practice Address - Street 1:255 SOUTH 17TH STREET
Practice Address - Street 2:SUITE 1509
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-2813
Practice Address - Country:US
Practice Address - Phone:215-790-1071
Practice Address - Fax:215-545-5384
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY028180R104100000X
PAPACW000937L1041C0700X
PAPA-CW-000937-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA60937Medicare ID - Type Unspecified