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General NPI Number Information
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NPI Number | 1144052515
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Entity Type | Individual
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Provider Name | DEBORAH ANN SOMUK-ATSIDIS
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Gender | Female
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Dates
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Enumeration Date | 08/15/2024
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Last Update Date | 12/15/2024
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Provider Practice Location Address
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Address Line | 413 VIRGINIA AVE
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City | AMBRIDGE
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State | PA
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Zip | 15003-1604
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Country | US
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Telephone | 239-822-0118
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Fax |
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Provider Business Mailing Address
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Address Line | 413 VIRGINIA AVE
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City | AMBRIDGE
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State | PA
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Zip | 15003-1604
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Country | US
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Telephone | 239-822-0118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW141638
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | DP00946945
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 039610
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14648
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089.0136018
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License Number State | VT
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