Provider Demographics
NPI:1437387628
Name:MOCIK, JOHN JOSEPH (LSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:MOCIK
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 BEAVER DRIVE
Mailing Address - Street 2:SUITE 117D
Mailing Address - City:DUBOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801
Mailing Address - Country:US
Mailing Address - Phone:814-371-1340
Mailing Address - Fax:
Practice Address - Street 1:90 BEAVER DR
Practice Address - Street 2:SUITE 117D
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2440
Practice Address - Country:US
Practice Address - Phone:814-371-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA126590104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker