Provider Demographics
NPI:1578001939
Name:TOCKER, MARCY
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:
Last Name:TOCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 BLATTADAHL RD
Mailing Address - Street 2:
Mailing Address - City:MOHRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19541-9212
Mailing Address - Country:US
Mailing Address - Phone:610-655-5271
Mailing Address - Fax:
Practice Address - Street 1:1164 BLATTADAHL RD
Practice Address - Street 2:
Practice Address - City:MOHRSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19541-9212
Practice Address - Country:US
Practice Address - Phone:610-655-5271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health