Healthcare Provider Details

I. General information

NPI: 1629318225
Provider Name (Legal Business Name): ERIN DAQUELENTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 10/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 FREEPORT RD SUITE 325
PITTSBURGH PA
15238-3131
US

IV. Provider business mailing address

100 RUTLEDGE DR
PITTSBURGH PA
15215-1920
US

V. Phone/Fax

Practice location:
  • Phone: 412-219-4743
  • Fax: 412-781-5362
Mailing address:
  • Phone: 412-600-1226
  • Fax: 412-781-5362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCW-SW128097
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017888
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: