Healthcare Provider Details

I. General information

NPI: 1154569051
Provider Name (Legal Business Name): CHRISTINE KILLCOYNE L.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3029 DRIFTING DR
HELLERTOWN PA
18055-9605
US

IV. Provider business mailing address

3029 DRIFTING DR
HELLERTOWN PA
18055-9605
US

V. Phone/Fax

Practice location:
  • Phone: 215-791-2268
  • Fax:
Mailing address:
  • Phone: 215-791-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW012466L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: