MEDICARE: HALEY N MOCK M.ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1023518388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY N MOCK M.ED

Provider Business Mailing Address
First Line	:	205 STATE ST
Second Line	:
City	:	WOODBURY
State	:	PA
Zip	:	16695-9400
Country	:	US
Telephone Number	:	814-369-0208
Fax Number	:

Provider Business Practice Location Address
First Line	:	793 OLD ROUTE 119 HWY NORTH
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701
Country	:	US
Telephone Number	:	724-465-5576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2018
Last Update Date	:	05/19/2026

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