Individual
MS. GWENDOLYN K BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
344 N READING RD, EPHRATA, PA 17522-1651
(717) 738-1125
(717) 738-0606
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904004052
VA
1041C0700X
Clinical Social Worker
Primary
CW018315
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103626033
—
PA
01
—
12571606
CAQH
—
01
—
C06778
GROUP PTAN
VA
01
—
CW018315
STATE LICENSE
PA
Enumeration date
06/24/2013
Last updated
05/28/2024
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