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NPI Code Detail

MEDICARE: STEPHEN R WOOCK LCSW

MEDICARE: STEPHEN R WOOCK 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
11041C0700XClinical Social Worker39000726IN

General Provider Information

NPI Number : 1619913837
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN R WOOCK LCSW
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number : 317-962-3834
Fax Number :
Provider Business Practice Location Address
First Line : 6820 PARKDALE PL
Second Line : STE 115
City : INDIANAPOLIS
State : IN
Zip : 46254-4699
Country : US
Telephone Number : 317-329-7300
Fax Number : 317-329-7325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 02/17/2020

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Directions to “ STEPHEN R WOOCK LCSW” Practice Location

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