James R Channick, MSW, LCSW
Individual provider Active NPI Counselor · Jamison, PA
NPI 1508109851 · NPPES record last updated Apr 4, 2013
Key facts
- NPI
- 1508109851
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- CW014679 (PA)
- Practice address
- 2500 York Rd
Suite 145
Jamison, PA 18929-1068 - Phone
- (610) 644-6464
- Fax
- (610) 981-6078
- NPI assigned
- Apr 4, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW014679 | PA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CW014679 | PA | Yes |
Addresses
Primary practice location
2500 York Rd
Suite 145
Jamison, PA 18929-1068
Mailing address
1440 Russell Rd
Paoli, PA 19301-1236
Phone (610) 644-6464
Other providers in Jamison, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.