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General NPI Number Information
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NPI Number | 1285117887
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Entity Type | Individual
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Provider Name | CAANEN M CHURUKHA LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 2643 N 3RD ST STE 2-302
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City | HARRISBURG
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State | PA
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Zip | 17110-2048
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Country | US
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Telephone | 717-557-9119
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Fax |
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Provider Business Mailing Address
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Address Line | 134 ROBIN LN APT O4
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-8239
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Country | US
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Telephone | 717-524-8165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW022447
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License Number State | PA
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