Ellen Brock | Media, PA • PECOS Search

Ellen Brock

Social Worker

Behavioral Health & Social Service Providers

280 N Providence Rd Ste 2, Media, PA 19063-3525

PECOS Enrollment

Based on the most recent information from CMS, provider Ellen Brock does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1174373328
Provider Type
Individual
Full Name
Brock, Ellen
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
3/22/2024
Last Updated
3/22/2024

Contact Information

Practice Location

280 N Providence Rd Ste 2, Media, PA 19063-3525

Unlisted Fax

Mailing Location

62 Old Lancaster Rd, Devon, PA 19333-1307

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License CW021094 Pennsylvania