Provider Demographics
NPI:1902932163
Name:SCHRECK, CAROL M (DMIN)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:M
Last Name:SCHRECK
Suffix:
Gender:F
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CABOT DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5619
Mailing Address - Country:US
Mailing Address - Phone:610-296-3319
Mailing Address - Fax:
Practice Address - Street 1:237 W LANCASTER AVE STE 215
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1585
Practice Address - Country:US
Practice Address - Phone:610-995-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000161106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMF000161OtherMARRIAGE&FAMILY THERAPIST