Healthcare Provider Details

I. General information

NPI: 1174809198
Provider Name (Legal Business Name): TODD PUNGRATZ LCSW, CAADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2011
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 PENN AVE
PITTSBURGH PA
15224-1305
US

IV. Provider business mailing address

105 BRAUNLICH DR STE 210
PITTSBURGH PA
15237-3351
US

V. Phone/Fax

Practice location:
  • Phone: 855-874-7763
  • Fax: 866-920-9559
Mailing address:
  • Phone: 412-367-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017787
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: