Individual
ELISABETH ANNE IACOVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
807 LAWN AVE, SELLERSVILLE, PA 18960-1549
(215) 257-6551
(215) 257-9347
Mailing address
1805 PENNLAND CT, LANSDALE, PA 19446-4332
(267) 210-3162
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW015211
PA
171M00000X
Case Manager/Care Coordinator
CW015211
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012718240002
—
PA
Enumeration date
07/03/2006
Last updated
08/25/2010
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