1245358308 NPI number — DARLENE DIGORIO-HEVNER, LLC

Table of content: MS. BHAGYA LAXMI KINTHALI PT (NPI 1144523747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245358308 NPI number — DARLENE DIGORIO-HEVNER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DARLENE DIGORIO-HEVNER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245358308
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 LONGVIEW CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERWYN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19312-2501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-868-0479
Provider Business Mailing Address Fax Number:
610-889-4839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
326 WEST LANCASTER AVENUE
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
ARDRMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-649-2267
Provider Business Practice Location Address Fax Number:
610-889-4839
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DIGORIO-HEVNER
Authorized Official First Name:
DARLENE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
LICENSED CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
484-868-0479

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CWO14625 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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