Provider Demographics
NPI:1376684613
Name:PLENDERLEITH, ANN ELIZABETH (CW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:ELIZABETH
Last Name:PLENDERLEITH
Suffix:
Gender:F
Credentials:CW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PINETOWN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2605
Mailing Address - Country:US
Mailing Address - Phone:215-643-0200
Mailing Address - Fax:215-643-9844
Practice Address - Street 1:550 PINETOWN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:FT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2605
Practice Address - Country:US
Practice Address - Phone:215-643-0200
Practice Address - Fax:215-643-9844
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0137001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7779517OtherAETNA
PA2321334000OtherPERSONAL CHOICE
PA275598000OtherMAGELLAN
PA275598000Medicaid
PA098988LRNMedicare ID - Type Unspecified