Provider Demographics
NPI:1326378944
Name:CHILCOTE, BRIAN WILLIAM (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:WILLIAM
Last Name:CHILCOTE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 BLACK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:COPLAY
Mailing Address - State:PA
Mailing Address - Zip Code:18037-2281
Mailing Address - Country:US
Mailing Address - Phone:484-866-5853
Mailing Address - Fax:
Practice Address - Street 1:2710 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-3574
Practice Address - Country:US
Practice Address - Phone:610-297-7500
Practice Address - Fax:610-297-7533
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0158261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical