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General NPI Number Information
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NPI Number | 1225477383
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Entity Type | Organization
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Legal Business Name | ELIZABETH S WILSON, LCSW, LLC
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 615 WASHINGTON RD SUITE 301
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City | PITTSBURGH
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State | PA
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Zip | 15228-1901
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Country | US
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Telephone | 412-343-0500
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Fax | 412-343-3875
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Provider Business Mailing Address
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Address Line | 615 WASHINGTON RD SUITE 301
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City | PITTSBURGH
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State | PA
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Zip | 15228-1901
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Country | US
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Telephone | 412-343-0500
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Fax | 412-343-3875
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. ELIZABETH SLAYTON WILSON
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Credential | LCSW
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Telephone | 412-343-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW016712
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License Number State | PA
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