Provider Demographics
NPI:1407446685
Name:BLOCK, CARRIE G (MA, MS)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:G
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7249 KINGSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:SLATINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18080-2217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7249 KINGSTEAD DR
Practice Address - Street 2:
Practice Address - City:SLATINGTON
Practice Address - State:PA
Practice Address - Zip Code:18080-2217
Practice Address - Country:US
Practice Address - Phone:443-567-9972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor