Doctor Name: | MR. MICHAEL SUCRO |
NPI Number: | 1043303712 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | CW014559 |
Business Practice Address: | Landmark Building, Route 209 Brodheadsville, PA - 18322 |
Business Phone Number: | 5702361106 |
Business Fax Number: | |
Mailing Address: | 238 Recreation Dr, EFFORT |
State: | PA |
Postal Code: | 183309038 |
Phone Number: | 5702361106 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 11/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW014559 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |