Provider Demographics
NPI:1972779841
Name:FAMILY SERVICES OF MONTGOMERY COUNTY
Entity Type:Organization
Organization Name:FAMILY SERVICES OF MONTGOMERY COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EAP/INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:DALE-ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:610-630-2111
Mailing Address - Street 1:1 E WYNNEWOOD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1918
Mailing Address - Country:US
Mailing Address - Phone:610-642-8890
Mailing Address - Fax:610-642-8986
Practice Address - Street 1:1 E WYNNEWOOD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1918
Practice Address - Country:US
Practice Address - Phone:610-642-8890
Practice Address - Fax:610-642-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA659570Medicare PIN