MEDICARE: J L SCHORCH LCSW PSC

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

General Provider Information

NPI Number	:	1730653767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J L SCHORCH LCSW PSC

Provider Business Mailing Address
First Line	:	1503 E BRECKINRIDGE ST
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1709
Country	:	US
Telephone Number	:	502-821-6309
Fax Number	:

Provider Business Practice Location Address
First Line	:	1167 E BROADWAY STE 400
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1768
Country	:	US
Telephone Number	:	502-821-6309
Fax Number	:

Authorized Official
Title or Position	:	LCSW
Name	:	MR. JAMES LOUIS SCHORCH
Credential	:
Telephone Number	:	502-821-6309

Provider Enumeration Date	:	01/12/2019
Last Update Date	:	01/12/2019

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