Provider Demographics
NPI:1831279843
Name:BETH A CANALICHIO LCSW LTD
Entity Type:Organization
Organization Name:BETH A CANALICHIO LCSW LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANALICHIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-734-7760
Mailing Address - Street 1:884 WALKER RD
Mailing Address - Street 2:SUITE 5C
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904
Mailing Address - Country:US
Mailing Address - Phone:302-734-7760
Mailing Address - Fax:302-734-7780
Practice Address - Street 1:884 WALKER RD
Practice Address - Street 2:SUITE 5C
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904
Practice Address - Country:US
Practice Address - Phone:302-734-7760
Practice Address - Fax:302-734-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE00004891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty