Individual provider Active NPI

Eileen Persichetti, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1194459578
Registry record updated Aug 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC200003102 Issued in DC
Practice address
850 N 11TH St
Philadelphia, PA 19123-1957
Phone
(503) 970-5903
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW026472 PA
Clinical Social Worker 1041C0700X LC200003102 DC Primary

Addresses

Primary practice location

850 N 11TH St
Philadelphia, PA 19123-1957

Mailing address

1344 E Palmer St
Philadelphia, PA 19125-3332
Phone (503) 970-5903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250102001533 DC Practitioner - Clinical Social Worker 3971030990 Reassigns benefits to 1 organization
I20251030005309 PA Practitioner - Clinical Social Worker 3971030990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1233 Locust St
FL 3
Philadelphia, PA 19107-5459

PO Box
Suite 5478
Pawtucket, RI 02862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LG200001261DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Marys Center for Maternal and Child Care Inc CurrentSince Nov 30, 2024 Accepting new patients
Mary's Center for Maternal and Child Care, Inc Multi-Specialty CurrentSince Nov 30, 2024 Accepting new patients
Philadelphia Fight CurrentSince Oct 20, 2025 Accepting new patients
Philadelphia Fight Multi-Specialty CurrentSince Oct 20, 2025 Accepting new patients

Locations

2333 Ontario Rd NW
Washington, DC 20009
Phone (202) 420-7175

1233 Locust St
Ste 500
Philadelphia, PA 19107
Phone (215) 790-1788

1233 Locust St
Fl 3
Philadelphia, PA 19107
Phone (267) 725-0252

1211 Chestnut St
Ste 605
Philadelphia, PA 19107
Phone (215) 525-8657

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788048000000",
    "number": "1194459578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 E PALMER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253332",
            "telephone_number": "503-970-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231957",
            "telephone_number": "503-970-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSICHETTI",
        "first_name": "EILEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2026-08-30",
        "certification_date": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW026472",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200003102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.