Provider Demographics
NPI:1215040704
Name:BERTINO, XANA S (LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:XANA
Middle Name:S
Last Name:BERTINO
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 N FRANKLIN ST STE 112-3
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3536
Mailing Address - Country:US
Mailing Address - Phone:267-935-9262
Mailing Address - Fax:
Practice Address - Street 1:16 N FRANKLIN ST STE 112-3
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-3536
Practice Address - Country:US
Practice Address - Phone:267-935-9262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0142361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical