Provider Demographics
NPI:1508473471
Name:JOUD, DANA (LSW)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:JOUD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 BALTIMORE AVE # 3F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3419
Mailing Address - Country:US
Mailing Address - Phone:267-314-7578
Mailing Address - Fax:
Practice Address - Street 1:1500 WALNUT ST STE 300
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3502
Practice Address - Country:US
Practice Address - Phone:267-314-7578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137451104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker