Provider Demographics
NPI:1558836171
Name:WALDES, JOCELYN (LCSW)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:WALDES
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 1:1818 RITTENHOUSE SQ
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5837
Mailing Address - Country:US
Mailing Address - Phone:267-606-0485
Mailing Address - Fax:
Practice Address - Street 1:1818 RITTENHOUSE SQ
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5837
Practice Address - Country:US
Practice Address - Phone:267-606-0485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059924001041C0700X
NY0874671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1932103413OtherGENERAL ACUTE CARE HOSPITAL