Healthcare Provider Details

I. General information

NPI: 1942784293
Provider Name (Legal Business Name): MEGAN WOLFSON LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2018
Last Update Date: 09/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BELLEFIELD AVE STE 4
PITTSBURGH PA
15213-2600
US

IV. Provider business mailing address

1405 SEVERN ST APT B4
PITTSBURGH PA
15217-1347
US

V. Phone/Fax

Practice location:
  • Phone: 412-624-1000
  • Fax:
Mailing address:
  • Phone: 760-831-2671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW134669
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: