Provider Demographics
NPI:1437465002
Name:MUTSCHLER, MARY K (MSW, LCSW,BCPCC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:MUTSCHLER
Suffix:
Gender:F
Credentials:MSW, LCSW,BCPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-0333
Mailing Address - Country:US
Mailing Address - Phone:717-602-8205
Mailing Address - Fax:
Practice Address - Street 1:4TH AND WALNUT STREETS
Practice Address - Street 2:GSH CHAPEL
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6165
Practice Address - Country:US
Practice Address - Phone:717-602-8205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0166851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical