Provider Demographics
NPI:1750112488
Name:AUDACITY SOCIAL WORK CONSULTANTS
Entity type:Organization
Organization Name:AUDACITY SOCIAL WORK CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SOCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:NIEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:610-314-8838
Mailing Address - Street 1:38 OAK ST
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-3708
Mailing Address - Country:US
Mailing Address - Phone:610-314-8838
Mailing Address - Fax:
Practice Address - Street 1:38 OAK ST
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-3708
Practice Address - Country:US
Practice Address - Phone:610-314-8838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care