Provider Demographics
NPI:1174034441
Name:ANNE UNTERKOEFLER LLC
Entity Type:Organization
Organization Name:ANNE UNTERKOEFLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINCAL SOCIAL WORK
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:UNTERKOEFLER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:484-350-5345
Mailing Address - Street 1:10 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2129
Mailing Address - Country:US
Mailing Address - Phone:610-246-0336
Mailing Address - Fax:610-644-7075
Practice Address - Street 1:7 W CENTRAL AVE STE 2A
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1378
Practice Address - Country:US
Practice Address - Phone:484-350-5345
Practice Address - Fax:610-644-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008973L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty