Provider Demographics
NPI:1205887387
Name:REICH, EMILY ROSE (MSW)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ROSE
Last Name:REICH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ROSE
Other - Last Name:REICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:1103 COVETRY AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:STE 202
Practice Address - City:HUNTINGTON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006
Practice Address - Country:US
Practice Address - Phone:215-914-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW012785101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
586185Medicare UPIN
PA029578N5MMedicare ID - Type Unspecified