Provider Demographics
NPI:1881102556
Name:HOESCH, DOUGLAS ALAN (LSW)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:ALAN
Last Name:HOESCH
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8821
Mailing Address - Country:US
Mailing Address - Phone:724-624-8076
Mailing Address - Fax:724-473-3258
Practice Address - Street 1:63 LAFAYETTE TRAIL
Practice Address - Street 2:
Practice Address - City:CHALK HIILL
Practice Address - State:PA
Practice Address - Zip Code:15421
Practice Address - Country:US
Practice Address - Phone:724-624-8076
Practice Address - Fax:724-473-3258
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1349471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical