Provider Demographics
NPI:1336189802
Name:WEIKEL, BEVERLY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:
Last Name:WEIKEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OFFICE CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3219
Mailing Address - Country:US
Mailing Address - Phone:215-540-2150
Mailing Address - Fax:215-540-8139
Practice Address - Street 1:340 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-2127
Practice Address - Country:US
Practice Address - Phone:570-366-5096
Practice Address - Fax:570-366-8755
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0120841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07759447Medicaid
PA033352NNPMedicare ID - Type Unspecified