Individual
IAN SILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSS, LSW
Contact information
Practice address
525 S 4TH ST STE 243, PHILADELPHIA, PA 19147-1573
(215) 925-3153
Mailing address
919 CARPENTER ST, PHILADELPHIA, PA 19147-3805
(856) 745-8632
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SW132599
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/25/2014
Last updated
07/21/2022
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