Provider Demographics
NPI:1649527375
Name:HOLUB, CHARLENE MARGARET (LSW)
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:MARGARET
Last Name:HOLUB
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:MARGARET
Other - Last Name:PEART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2500 NESHAMINY INTERPLEX DR
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6943
Mailing Address - Country:US
Mailing Address - Phone:267-991-7667
Mailing Address - Fax:
Practice Address - Street 1:2500 NESHAMINY INTERPLEX DR
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6943
Practice Address - Country:US
Practice Address - Phone:267-991-7667
Practice Address - Fax:267-991-7615
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW002767E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker