Provider Demographics
NPI:1457568032
Name:CAHILL, JOHN ANDREW (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ANDREW
Last Name:CAHILL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7246 HAZEL AVE
Mailing Address - Street 2:APT. A-3
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-3040
Mailing Address - Country:US
Mailing Address - Phone:610-352-4495
Mailing Address - Fax:215-487-1992
Practice Address - Street 1:6012 RIDGE AVE
Practice Address - Street 2:INTERAC GERIATRIC COUNSELING SERVICE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1643
Practice Address - Country:US
Practice Address - Phone:215-487-1990
Practice Address - Fax:215-487-1992
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008456L1041C0700X
FLSW54801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA769317Medicare ID - Type Unspecified