Provider Demographics
NPI:1205342672
Name:SCHOCH, NICOLE N (MSW, LCSW, CAADC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:N
Last Name:SCHOCH
Suffix:
Gender:F
Credentials:MSW, LCSW, CAADC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:N
Other - Last Name:GENTILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW, CAADC
Mailing Address - Street 1:9918 TREXLER RD
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1740
Mailing Address - Country:US
Mailing Address - Phone:484-809-2419
Mailing Address - Fax:
Practice Address - Street 1:1011 BROOKSIDE RD STE 320
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9020
Practice Address - Country:US
Practice Address - Phone:484-273-2572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0198721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical