Provider Demographics
NPI:1740341635
Name:CHESTER VALLEY COUNSELING CENTER
Entity type:Organization
Organization Name:CHESTER VALLEY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PSYCHOLOGICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHMUCKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:610-240-4827
Mailing Address - Street 1:967 E SWEDESFORD RD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2332
Mailing Address - Country:US
Mailing Address - Phone:610-240-4827
Mailing Address - Fax:610-240-4821
Practice Address - Street 1:967 E SWEDESFORD RD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2332
Practice Address - Country:US
Practice Address - Phone:610-240-4827
Practice Address - Fax:610-240-4821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0135181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTAX IDENTIFICATION