Provider Demographics
NPI:1194881995
Name:NUROCK, BRIDGET M (LCSW)
Entity type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:M
Last Name:NUROCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CHESWOLD LN
Mailing Address - Street 2:UNIT 4H
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1867
Mailing Address - Country:US
Mailing Address - Phone:484-416-3596
Mailing Address - Fax:484-416-3596
Practice Address - Street 1:600 HAVERFORD RD
Practice Address - Street 2:SUITE G104
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1139
Practice Address - Country:US
Practice Address - Phone:215-850-5872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO156071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA753537Medicare PIN