Healthcare Provider Details

I. General information

NPI: 1992720411
Provider Name (Legal Business Name): RAEANN MICHALKO L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 MONROEVILLE BLVD
MONROEVILLE PA
15146-2329
US

IV. Provider business mailing address

2540 MONROEVILLE BLVD
MONROEVILLE PA
15146-2329
US

V. Phone/Fax

Practice location:
  • Phone: 412-823-5155
  • Fax: 412-823-8262
Mailing address:
  • Phone: 412-823-5155
  • Fax: 412-823-8262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014075
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier4412
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUPMC
# 2
Identifier659407
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBC/BS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: