Basic Information
| Provider Information | |||||||||
| NPI: | 1174842108 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHENTOW | ||||||||
| FirstName: | HILARY | ||||||||
| MiddleName: | SWEEDLER | ||||||||
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| Credential: | M.S.S., L.C.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 MARYLAND RD | ||||||||
| Address2: | SUITE #400 | ||||||||
| City: | WILLOW GROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190901216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154813064 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 51 MEDICAL CAMPUS DR | ||||||||
| Address2: | |||||||||
| City: | LANSDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194461254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154815440 | ||||||||
| FaxNumber: | 2154815435 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2010 | ||||||||
| LastUpdateDate: | 01/04/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 103233018 | 05 | PA | MEDICAID |