MEDICARE: MRS. CHERYL A OSUCH LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	077142	NY
2	1041C0700X	Clinical Social Worker	CW019147	PA

General Provider Information

NPI Number	:	1043256365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL A OSUCH LCSW

Provider Business Mailing Address
First Line	:	1250 N MOUNTAIN RD STE 308
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1795
Country	:	US
Telephone Number	:	717-219-4147
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 N MOUNTAIN RD STE 308
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1795
Country	:	US
Telephone Number	:	717-219-4147
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/06/2020

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