Provider Demographics
NPI:1285486746
Name:MOCK, EDEN CHRISTINE (MSW, LCSW)
Entity type:Individual
Prefix:MISS
First Name:EDEN
Middle Name:CHRISTINE
Last Name:MOCK
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 N 450 E
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-9369
Mailing Address - Country:US
Mailing Address - Phone:260-820-1372
Mailing Address - Fax:
Practice Address - Street 1:1366 N 450 E
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-9369
Practice Address - Country:US
Practice Address - Phone:260-820-1372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009713A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical