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Individual

MRS. JERRY MOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
47 W POMFRET ST, CARLISLE, PA 17013-3217
(717) 258-0214
(717) 258-3158
Mailing address
47 W POMFRET ST, CARLISLE, PA 17013-3217
(717) 258-0214
(717) 258-3158

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
008898L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017562050002
PA
01
01082001
CAPITAL BLUE CROSS
PA
01
01756205
COMMUNITY BEH. HEALTH
PA
01
122278
VALUE OPTIONS
PA
01
322506
MHNET
PA
01
485274000
MAGELLAN
PA
01
595346
HIGHMARK BLUE SHIELD
PA
01
7134268
AETNA
PA
01
810554001
AETNA PPO
PA
01
MO595346
CIGNA
PA
Enumeration date
08/11/2005
Last updated
03/12/2010
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