Boulden, Mary Beth
Boulden, Mary Beth is an individual health care provider with primary practice located at 5501 Old York Rd Moss 1, Office 139, Philadelphia PA 19141-3018. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Boulden, Mary Beth can be contacted via phone (215) 456-9884.Contact Information
Primary practice address
5501 Old York Rd Moss 1, Office 139
Philadelphia PA 19141-3018
Phone: (215) 456-9884
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | PC000160 | Pennsylvania |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | SW124663 | Pennsylvania |
Profile Details
| NPI number | 1588627038 |
|---|---|
| LBN Legal business name | Boulden, Mary Beth |
| Credentials | LCSW, LPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2006 |
| Last updated | Oct 3rd, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588627038 | NPPES |
| Pennsylvania | Other | CW015559 | LCSW |
| Pennsylvania | Other | PC000160 | LCSW |
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