Provider Demographics
NPI:1063541068
Name:SACHS, EVELYN RUTH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:RUTH
Last Name:SACHS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:EVELYN
Other - Middle Name:RUTH
Other - Last Name:HUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:236 PHILIP PLACE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106
Mailing Address - Country:US
Mailing Address - Phone:215-922-4682
Mailing Address - Fax:
Practice Address - Street 1:2100 ARCH STREET
Practice Address - Street 2:5TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103
Practice Address - Country:US
Practice Address - Phone:215-496-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000008810025OtherWELFARE MEDICAID
PA1000008810009Medicaid
PA1000008810009Medicaid