Provider Demographics
NPI:1760553275
Name:FLOCK, ALLEN D (MSW)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:D
Last Name:FLOCK
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FARLEY CIR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9252
Mailing Address - Country:US
Mailing Address - Phone:570-743-1055
Mailing Address - Fax:570-523-2039
Practice Address - Street 1:115 FARLEY CIR
Practice Address - Street 2:SUITE 108
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9252
Practice Address - Country:US
Practice Address - Phone:570-743-1055
Practice Address - Fax:570-523-2039
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-009215-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical