Provider Demographics
NPI:1548393838
Name:WARSAW, LORI ELLYN (MSW LSW)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ELLYN
Last Name:WARSAW
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 ARCH ST
Mailing Address - Street 2:5TH FLOOR JEWISH FAMILY & CHILDRENS SERV
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1300
Mailing Address - Country:US
Mailing Address - Phone:215-496-9700
Mailing Address - Fax:215-496-0833
Practice Address - Street 1:2100 ARCH ST
Practice Address - Street 2:5TH FLOOR JFCS
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1300
Practice Address - Country:US
Practice Address - Phone:215-496-9700
Practice Address - Fax:215-496-0833
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000008890009Medicaid