Healthcare Provider Details

I. General information

NPI: 1659841286
Provider Name (Legal Business Name): CATHERINE MCEWEN WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 OLD HAYMAKER ROAD SUITE 1102
MONROEVILLE PA
15146
US

IV. Provider business mailing address

3811 O'HARA STREET 10TH FLOOR
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-824-4005
  • Fax: 412-824-4006
Mailing address:
  • Phone: 412-246-6798
  • Fax: 412-246-6797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018570
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: