Provider Demographics
NPI:1528397882
Name:NEWDECK, SHAWN (MSW)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:NEWDECK
Suffix:
Gender:F
Credentials:MSW
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 2:350
Mailing Address - City:FORT 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 2:350
Practice Address - City:FORT 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?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical