Healthcare Provider Details

I. General information

NPI: 1255262010
Provider Name (Legal Business Name): STEPHANIE ESDAILE CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7157 MARY PECK BOND PL
PITTSBURGH PA
15206-1236
US

IV. Provider business mailing address

140 LAVALE DR APT 712
MONROEVILLE PA
15146-2932
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-2802
  • Fax: 412-661-8020
Mailing address:
  • Phone: 203-710-3984
  • Fax: 412-661-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: