Provider Demographics
NPI:1255634036
Name:SECHRIST, CORIE (LBS, CCHW, LPN)
Entity type:Individual
Prefix:
First Name:CORIE
Middle Name:
Last Name:SECHRIST
Suffix:
Gender:F
Credentials:LBS, CCHW, LPN
Other - Prefix:
Other - First Name:CORIE
Other - Middle Name:
Other - Last Name:SECHRIST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BEHAVIOR SPECIALIST
Mailing Address - Street 1:121 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:HOPWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15445-2114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:HOPWOOD
Practice Address - State:PA
Practice Address - Zip Code:15445-2114
Practice Address - Country:US
Practice Address - Phone:724-555-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN273413164W00000X
PA18496172V00000X
PABH006797103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABH006797OtherPENNSYLVANIA BOARD OF MEDICINE