Active NPI
Christie Eastburn
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1609495159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW131922
- Practice address
- 1229 S 6TH St
Philadelphia, PA 19147-4837 - Phone
- (267) 419-7574
- NPI assigned
- Apr 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW131922 | PA | Primary |
Addresses
Primary practice location
1229 S 6TH St
Philadelphia, PA 19147-4837
Mailing address
1229 Harrison St
Philadelphia, PA 19124-2909
Phone (302) 229-2082
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.christieeastburntherapy.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW131922 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1609495159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 HARRISON ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191242909",
"telephone_number": "302-229-2082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 S 6TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191474837",
"telephone_number": "267-419-7574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTBURN",
"first_name": "CHRISTIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "SW131922",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.christieeastburntherapy.com",
"affiliation": "N",
"endpointDescription": "practice website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1229 S 6th St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191474837",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Philadelphia, PA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.