Provider Demographics
NPI:1467518282
Name:ACTON, VIVIAN L (LCSW)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:L
Last Name:ACTON
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 1:1100 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3820
Mailing Address - Country:US
Mailing Address - Phone:610-277-4600
Mailing Address - Fax:610-277-4651
Practice Address - Street 1:1100 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3820
Practice Address - Country:US
Practice Address - Phone:610-277-4600
Practice Address - Fax:610-277-4651
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0150061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P52904Medicare UPIN
PA055192GNYMedicare ID - Type Unspecified