Provider Demographics
NPI:1861366866
Name:VERNICK, GARY IRWIN
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:IRWIN
Last Name:VERNICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 HAGYS FORD RD
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1051
Mailing Address - Country:US
Mailing Address - Phone:610-721-8745
Mailing Address - Fax:
Practice Address - Street 1:1600 HAGYS FORD RD
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072-1051
Practice Address - Country:US
Practice Address - Phone:610-721-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty