Provider Demographics
NPI:1508465170
Name:SHONDECK, STACY LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:LYNN
Last Name:SHONDECK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LOGANS FERRY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-2048
Mailing Address - Country:US
Mailing Address - Phone:724-994-4715
Mailing Address - Fax:
Practice Address - Street 1:125 LOGANS FERRY RD STE 2
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-2048
Practice Address - Country:US
Practice Address - Phone:724-994-4715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker