Healthcare Provider Details

I. General information

NPI: 1609925395
Provider Name (Legal Business Name): JEANNE M HEPBURN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6324 MARCHAND ST
PITTSBURGH PA
15206-4312
US

IV. Provider business mailing address

249 INGLEWOOD DR
PITTSBURGH PA
15228-1507
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-1239
  • Fax: 412-661-1304
Mailing address:
  • Phone: 412-561-6006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014369
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: