Provider Demographics
NPI:1053158295
Name:CHAO, STEPHEN (MSW, LSW)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:CHAO
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4516 WALNUT ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4503
Mailing Address - Country:US
Mailing Address - Phone:512-944-2128
Mailing Address - Fax:
Practice Address - Street 1:112 E ALLEN ST UNIT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-4189
Practice Address - Country:US
Practice Address - Phone:215-278-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141681104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker