Provider Demographics
NPI:1013450246
Name:MAROUCHOC, CHRISTOPHER (LSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MAROUCHOC
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-1206
Mailing Address - Country:US
Mailing Address - Phone:610-657-8883
Mailing Address - Fax:
Practice Address - Street 1:62 SALEM RD
Practice Address - Street 2:
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-1206
Practice Address - Country:US
Practice Address - Phone:610-657-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-20
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131891104100000X
PACW0234171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker