Healthcare Provider Details

I. General information

NPI: 1760346472
Provider Name (Legal Business Name): NICOLE GUERCIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

643 MAIN ST
SLATINGTON PA
18080-1458
US

IV. Provider business mailing address

214 COLLEGE PARK PLZ
JOHNSTOWN PA
15904-2833
US

V. Phone/Fax

Practice location:
  • Phone: 610-224-9311
  • Fax: 814-266-2880
Mailing address:
  • Phone: 814-262-0025
  • Fax: 814-266-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW143718
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: