Provider Demographics
NPI:1720466956
Name:SOCOLOSCHI, ANDREEA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREEA
Middle Name:
Last Name:SOCOLOSCHI
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 1:230 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1095
Mailing Address - Country:US
Mailing Address - Phone:727-225-5288
Mailing Address - Fax:
Practice Address - Street 1:230 N 21ST ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1095
Practice Address - Country:US
Practice Address - Phone:727-225-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0192671041C0700X
FLSW139021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical