Provider Demographics
NPI:1164723813
Name:CHESTER VALLEY COUNSELING CENTER
Entity Type:Organization
Organization Name:CHESTER VALLEY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHMUCKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:610-594-7594
Mailing Address - Street 1:201 EXTON COMMONS
Mailing Address - Street 2:201
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:610-594-7594
Mailing Address - Fax:610-594-7595
Practice Address - Street 1:201 EXTON COMMONS
Practice Address - Street 2:201
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:610-594-7594
Practice Address - Fax:610-594-7595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW002002E1041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty