Provider Demographics
NPI:1659085967
Name:ACKOUREY, ABIGAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:ACKOUREY
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 1:700 LOWER STATE RD APT 16C3
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2120
Mailing Address - Country:US
Mailing Address - Phone:215-605-4686
Mailing Address - Fax:
Practice Address - Street 1:1031 OLD CASSATT RD STE 100
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1152
Practice Address - Country:US
Practice Address - Phone:480-660-8757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0207161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical