Provider Demographics
NPI:1205499803
Name:SZUMOWSKA, EWA (LPC)
Entity type:Individual
Prefix:
First Name:EWA
Middle Name:
Last Name:SZUMOWSKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 GERMANTOWN PIKE STE G5
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2487
Mailing Address - Country:US
Mailing Address - Phone:610-647-0330
Mailing Address - Fax:484-322-2131
Practice Address - Street 1:240 FITZWATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2332
Practice Address - Country:US
Practice Address - Phone:610-647-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC007482OtherSUBACUTE SUBSTANCE ABUSE RESIDENTIAL TREATMENT