MEDICARE: KATLYN KROECK

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1730036484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATLYN KROECK

Provider Business Mailing Address
First Line	:	113 GRANT ST
Second Line	:
City	:	EPHRATA
State	:	PA
Zip	:	17522-2211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 S 4TH ST STE 598
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1581
Country	:	US
Telephone Number	:	267-585-2980
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “ KATLYN KROECK ” Practice Location

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