Individual provider Active NPI

Daniella Alcin Libertino, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1396103792
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018893 Issued in PA
Practice address
1924 Waverly St
Philadelphia, PA 19146-1425
Phone
(646) 409-8086
NPI assigned
Feb 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW018893 PA Primary

Addresses

Primary practice location

1924 Waverly St
Philadelphia, PA 19146-1425

Mailing address

1924 Waverly St
Philadelphia, PA 19146-1425
Phone (646) 409-8086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice & Counseling Services Network, Inc. CurrentSince Nov 5, 2016 Accepting new patients
Family Practice & Counseling Services Network, Inc. CurrentSince Nov 5, 2016 Accepting new patients
Resources for Human Development, Inc. Current Accepting new patients
Family Practice & Counseling Services Network, Inc. Past Accepting new patients
Resources for Human Development, Inc. Past Accepting new patients

Locations

6120 Woodland Ave
Fl The
Philadelphia, PA 19142
Phone (215) 727-4721

4700 Wissahickon Ave
Ste 118
Philadelphia, PA 19144
Phone 26759736006771

2300 W Master St
Philadelphia, PA 19121
Phone (267) 687-1172

4700 Wissahickon Ave
Bldg D
Philadelphia, PA 19144
Phone (215) 843-9720

Organizations & group practices 5

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": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1396103792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 WAVERLY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461425",
            "telephone_number": "646-409-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 WAVERLY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461425",
            "telephone_number": "646-409-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERTINO",
        "first_name": "DANIELLA",
        "middle_name": "ALCIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.