Basic Information
Provider Information
NPI: 1205992500
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAY
FirstName: PATRICIA
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1303 ANNA AVE
Address2:  
City: WEST MIFFLIN
State: PA
PostalCode: 151223747
CountryCode: US
TelephoneNumber: 4124660544
FaxNumber:  
Practice Location
Address1: 6324 MARCHAND ST
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152064312
CountryCode: US
TelephoneNumber: 4126611239
FaxNumber: 4126611304
Other Information
ProviderEnumerationDate: 12/29/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XCW013933PAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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