Provider Demographics
NPI:1912072752
Name:TAKIFF, AVRIL HOPE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AVRIL
Middle Name:HOPE
Last Name:TAKIFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:AVRIL
Other - Middle Name:HOPE
Other - Last Name:TAKIFF WEINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2321 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLMAR
Mailing Address - State:PA
Mailing Address - Zip Code:18915
Mailing Address - Country:US
Mailing Address - Phone:215-997-3600
Mailing Address - Fax:215-997-9409
Practice Address - Street 1:2321 N BROAD ST
Practice Address - Street 2:
Practice Address - City:COLMAR
Practice Address - State:PA
Practice Address - Zip Code:18915
Practice Address - Country:US
Practice Address - Phone:215-997-3600
Practice Address - Fax:215-997-9409
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014621103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist