Provider Demographics
NPI:1427120088
Name:GARSON, WILLIAM JEFFREY (LCSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JEFFREY
Last Name:GARSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FLOURTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1205
Mailing Address - Country:US
Mailing Address - Phone:215-450-4306
Mailing Address - Fax:610-525-1935
Practice Address - Street 1:60 FLOURTOWN RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1205
Practice Address - Country:US
Practice Address - Phone:215-450-4306
Practice Address - Fax:610-525-1935
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0149461041C0700X, 103TB0200X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2458437000OtherINDEPENDENCE BLUE CROSS