Healthcare Provider Details

I. General information

NPI: 1780096693
Provider Name (Legal Business Name): LAUREN MERCLEAN L.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 DARBY RD STE F
PAOLI PA
19301-1480
US

IV. Provider business mailing address

4019 WINTERBURN AVE
PITTSBURGH PA
15207-1158
US

V. Phone/Fax

Practice location:
  • Phone: 484-321-6277
  • Fax:
Mailing address:
  • Phone: 412-246-5338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW 129206
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018251
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: