Healthcare Provider Details

I. General information

NPI: 1265023691
Provider Name (Legal Business Name): WILLIAM H MAYS III LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CASTE VILLAGE PLAZA 5301 GROVE RD M123
PITTSBURGH PA
15236
US

IV. Provider business mailing address

113 TROTWOOD DR
CANONSBURG PA
15317-9783
US

V. Phone/Fax

Practice location:
  • Phone: 412-677-9100
  • Fax:
Mailing address:
  • Phone: 412-952-7288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW137789
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: