Provider Demographics
NPI:1689776726
Name:KACHER, BRUCE GLENN (LCSW)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:GLENN
Last Name:KACHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2515
Mailing Address - Country:US
Mailing Address - Phone:302-571-9004
Mailing Address - Fax:215-886-7678
Practice Address - Street 1:8302 OLD YORK RD
Practice Address - Street 2:S-12
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1522
Practice Address - Country:US
Practice Address - Phone:215-885-9700
Practice Address - Fax:215-886-7678
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0127001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA633748Medicare ID - Type Unspecified