Provider Demographics
NPI:1295801686
Name:PORRECA, ANDREA MOCKRIK (MSS, LCSW)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:MOCKRIK
Last Name:PORRECA
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3812
Mailing Address - Country:US
Mailing Address - Phone:215-886-1842
Mailing Address - Fax:215-886-1799
Practice Address - Street 1:1842 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3812
Practice Address - Country:US
Practice Address - Phone:215-886-1842
Practice Address - Fax:215-886-1799
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0160671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical