Supportive Older Women'S Network

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

SUPPORTIVE OLDER WOMEN'S NETWORK

Practice address

4100 Main St Ste 403
Philadelphia, PA 19127-1623

Phone

(215) 487-3000

Fax

(215) 487-3111

NPI assigned

Dec 7, 2010

Organization subpart

No

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

Authorized official

Name

Marypat B Tracy

Title

Executive Director

Phone

(215) 487-3000

Specialties & licenses 2

Addresses

Other names 1

• Connectedly Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eileen B Addis, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1336657709
  NPD (past)
• Layla Ware de Luria, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1528447133
  NPD (past)

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1245533660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 MAIN ST STE 403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MAIN ST STE 403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271623",
            "telephone_number": "215-487-3000",
            "fax_number": "215-487-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE OLDER WOMEN'S NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-07",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "MARYPAT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-487-3000"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connectedly",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Supplying With Care
• Support Beam Home Care LLC
• Supportive Behavioral Resources, Inc.
• Supportive Care Solutions, LLC
• Supportive Home Care Services LLC
• Supportive Transpotation of Philadelphia Inc.
• Supports Your Way LLC
• Supreme Healthcare LLC
• Sara Supriyatno, DDS
• Pradeep Kumar Sure

• Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.