Provider Demographics
NPI:1104634260
Name:WARE, JAMIE MARIE (MSW, LSW, JD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:WARE
Suffix:
Gender:F
Credentials:MSW, LSW, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 DAY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3903
Mailing Address - Country:US
Mailing Address - Phone:702-419-6286
Mailing Address - Fax:
Practice Address - Street 1:3580 INDIAN QUEEN LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1540
Practice Address - Country:US
Practice Address - Phone:215-774-1306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141014104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker