1003365628 NPI number — SOCIAL WORK CONSULTING AND COUNSELING LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003365628 NPI number — SOCIAL WORK CONSULTING AND COUNSELING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOCIAL WORK CONSULTING AND COUNSELING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SWCC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003365628
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1007 PREMIER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15201-2154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-204-6934
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
910 BRADDOCK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRADDOCK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15104-1717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-204-6934
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2016

Additional Information

Authorized Official

Authorized Official Last Name:
GURLEY
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER / THERAPIST
Authorized Official Telephone Number:
412-204-6934

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  CW018857 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CW018857 . This is a "SOCIAL WORK STATE BOARDS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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