Provider Demographics
NPI:1205907078
Name:SCHANK, CAROL F (LCSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:F
Last Name:SCHANK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 COMMUNITY SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-8915
Mailing Address - Country:US
Mailing Address - Phone:570-366-5096
Mailing Address - Fax:570-366-8755
Practice Address - Street 1:340 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-2127
Practice Address - Country:US
Practice Address - Phone:570-366-5096
Practice Address - Fax:570-366-8755
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1248081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1885570OtherBLUE SHIELD