Healthcare Provider Details

I. General information

NPI: 1740341635
Provider Name (Legal Business Name): CHESTER VALLEY COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 E SWEDESFORD RD
EXTON PA
19341-2332
US

IV. Provider business mailing address

967 E SWEDESFORD RD
EXTON PA
19341-2332
US

V. Phone/Fax

Practice location:
  • Phone: 610-240-4827
  • Fax: 610-240-4821
Mailing address:
  • Phone: 610-240-4827
  • Fax: 610-240-4821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013518
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RICHARD J SCHMUCKI
Title or Position: DIRECTOR OF PSYCHOLOGICAL SERVICES
Credential: LCSW
Phone: 610-240-4827