Provider Demographics
NPI:1659736650
Name:STACHOWICZ, CARRIE (LSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:STACHOWICZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4833 HULMEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-3023
Mailing Address - Country:US
Mailing Address - Phone:215-638-5200
Mailing Address - Fax:215-638-2581
Practice Address - Street 1:195 BRISTOL OXFORD VALLEY RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-3050
Practice Address - Country:US
Practice Address - Phone:215-946-4029
Practice Address - Fax:215-946-4353
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131065104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker