Healthcare Provider Details

I. General information

NPI: 1619907466
Provider Name (Legal Business Name): STEPHEN MICHAEL SCHUCH MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 NORWOOD RD
COLUMBIA PA
17512-9415
US

IV. Provider business mailing address

520 NORWOOD RD
COLUMBIA PA
17512-9415
US

V. Phone/Fax

Practice location:
  • Phone: 717-413-1307
  • Fax: 717-838-8881
Mailing address:
  • Phone: 717-413-1307
  • Fax: 717-838-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW002920L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: