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NPI Code Detail

MEDICARE: MRS. MISTY SUE SHIELDS M.S.W., L.C.S.W

MEDICARE: MRS. MISTY SUE SHIELDS M.S.W., L.C.S.W
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerSW126028PA
2174400000XSpecialistCW016341PA
3174400000XSpecialist
41041C0700XClinical Social WorkerCW016341PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457335952
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MISTY SUE SHIELDS M.S.W., L.C.S.W
Provider Business Mailing Address
First Line : 7180 HIGHLAND DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-1206
Country : US
Telephone Number : 724-954-4194
Fax Number :
Provider Business Practice Location Address
First Line : 7180 HIGHLAND DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-1206
Country : US
Telephone Number : 724-954-4194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 07/15/2021

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Directions to “ MRS. MISTY SUE SHIELDS M.S.W., L.C.S.W” Practice Location

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