Provider Demographics
NPI:1821400334
Name:ELGAMIL, NIKOO RAOOFIAN (LCSW)
Entity Type:Individual
Prefix:
First Name:NIKOO
Middle Name:RAOOFIAN
Last Name:ELGAMIL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NIKOO
Other - Middle Name:
Other - Last Name:RAOOFIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:10541 DRUMMOND RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-3807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10541 DRUMMOND RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3807
Practice Address - Country:US
Practice Address - Phone:215-612-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0180541041C0700X
MD157431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical