Healthcare Provider Details

I. General information

NPI: 1376253435
Provider Name (Legal Business Name): CHAD GURDGIEL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 LAUREL OAK RD STE 7
VOORHEES NJ
08043-3509
US

IV. Provider business mailing address

502 W 7TH ST
ERIE PA
16502-1333
US

V. Phone/Fax

Practice location:
  • Phone: 856-229-0875
  • Fax:
Mailing address:
  • Phone: 267-603-6968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06670400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW026354
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: