1619907466 NPI number — MR. STEPHEN MICHAEL SCHUCH MSW

Table of content: DR. ERICA MATHIS PH.D. (NPI 1790375350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619907466 NPI number — MR. STEPHEN MICHAEL SCHUCH MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUCH
Provider First Name:
STEPHEN
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619907466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 NORWOOD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17512-9415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-413-1307
Provider Business Mailing Address Fax Number:
717-838-8881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 NORWOOD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17512-9415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-413-1307
Provider Business Practice Location Address Fax Number:
717-838-8881
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW002920L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SC644663 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007624245 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0320801 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 229815000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 230092 . This is a "MHN, INC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001662013 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100028157001 . This is a "APS HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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