Provider Demographics
NPI:1770094096
Name:SOCKRITER, CORY A
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:A
Last Name:SOCKRITER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 HEREFORDSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-5831
Mailing Address - Country:US
Mailing Address - Phone:610-291-2836
Mailing Address - Fax:
Practice Address - Street 1:245 BETHEL RD
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1561
Practice Address - Country:US
Practice Address - Phone:610-938-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011794101YM0800X
NJ37PC00915700101YM0800X
101YM0800X
TX83410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA231637191Medicaid