1205342672 NPI number — NICOLE N SCHOCH MSW, LCSW, CAADC

Table of content: (NPI 1659595791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205342672 NPI number — NICOLE N SCHOCH MSW, LCSW, CAADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHOCH
Provider First Name:
NICOLE
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW, CAADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GENTILE
Provider Other First Name:
NICOLE
Provider Other Middle Name:
N
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW, LSW, CAADC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1205342672
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9918 TREXLER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BREINIGSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18031-1740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-809-2419
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1011 BROOKSIDE RD STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-9020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-273-2572
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2017

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:  CW019872 , 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)





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