Healthcare Provider Details

I. General information

NPI: 1356205280
Provider Name (Legal Business Name): BRIELLE WOODSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 WALNUT ST
MCKEESPORT PA
15132-2801
US

IV. Provider business mailing address

117 OAK AVE
PENN HILLS PA
15235-4349
US

V. Phone/Fax

Practice location:
  • Phone: 412-298-6258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: