Schock, Kathleen Diane

Schock, Kathleen Diane is an individual health care provider with primary practice located at 103 Jasmine Cir , Milford CT 06461-1789. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Schock, Kathleen Diane can be contacted via phone (203) 882-1457.

Contact Information

Primary practice address
103 Jasmine Cir Milford CT 06461-1789
Phone: (203) 882-1457
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 000723 Connecticut
Behavioral Health & Social Service Providers / Professional 101YP2500X 001435 Connecticut

Profile Details

NPI number 1194819102
LBN Legal business name Schock, Kathleen Diane
Credentials M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Aug 8th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194819102 NPPES
Connecticut MEDICAID 008038045

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