Individual provider Active NPI

Christopher Famiglietti, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1801279039
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW019873 Issued in PA
Practice address
255 S 17TH St Ste 2100
Philadelphia, PA 19103-6211
Phone
(484) 420-6636
NPI assigned
Jul 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 NJ
Clinical Social Worker 1041C0700X CW019873 PA Primary

Addresses

Primary practice location

255 S 17TH St Ste 2100
Philadelphia, PA 19103-6211

Mailing address

255 S 17TH St Ste 2100
Philadelphia, PA 19103-6211
Phone (484) 420-6636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190614000652 PA Practitioner - Clinical Social Worker 7911230438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW019873PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Psychological PC CurrentSince Apr 25, 2019 Accepting new patients

Locations

1420 Walnut St
Ste 1500
Philadelphia, PA 19102
Phone (610) 544-2100

1489 Baltimore Pike
Ste 250
Springfield, PA 19064
Phone 6105442110144

Organizations & group practices 1

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1801279039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 2100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036211",
            "telephone_number": "484-420-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 2100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036211",
            "telephone_number": "484-420-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMIGLIETTI",
        "first_name": "CHRISTOPHER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.