Provider Demographics
NPI:1134750987
Name:STETSON, NENA OGLESBY (LCSW)
Entity type:Individual
Prefix:
First Name:NENA
Middle Name:OGLESBY
Last Name:STETSON
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 1:11 TANGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2030
Mailing Address - Country:US
Mailing Address - Phone:484-612-3538
Mailing Address - Fax:
Practice Address - Street 1:390 REED RD FL 1
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-4008
Practice Address - Country:US
Practice Address - Phone:484-450-6476
Practice Address - Fax:484-224-3398
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0211901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical