Individual
MR. DORI EVEN-SHOSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1200 CALLOWHILL ST, PHILADELPHIA, PA 19123-3658
(215) 825-8220
Mailing address
1200 CALLOWHILL ST, PHILADELPHIA, PA 19123-3658
(215) 825-8220
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
CW022189
PA
1041C0700X
Clinical Social Worker
SW130494
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
OR
Enumeration date
11/30/2016
Last updated
01/18/2023
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