MEDICARE: MISS STEPHANE MARIE ELISCO LSW, MPA

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
1	104100000X	Social Worker	CW022523	PA

General Provider Information

NPI Number	:	1467421123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS STEPHANE MARIE ELISCO LSW, MPA

Provider Business Mailing Address
First Line	:	3103 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1131
Country	:	US
Telephone Number	:	724-944-5810
Fax Number	:

Provider Business Practice Location Address
First Line	:	3103 WILMINGTON RD STE 2
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1131
Country	:	US
Telephone Number	:	724-944-5810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	01/20/2026

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