Provider Demographics
NPI:1992901169
Name:SCHULMAN, CARLY JOANNA (MSS, LSW)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:JOANNA
Last Name:SCHULMAN
Suffix:
Gender:F
Credentials:MSS, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3109
Mailing Address - Country:US
Mailing Address - Phone:610-453-8278
Mailing Address - Fax:
Practice Address - Street 1:1201 CHESTNUT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4123
Practice Address - Country:US
Practice Address - Phone:215-563-0663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1261681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical