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General NPI Number Information
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NPI Number | 1235357625
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Entity Type | Individual
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Provider Name | SUSAN ELAINE MCANINCH LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 CORPORATE CIR
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City | GREENSBURG
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State | PA
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Zip | 15601-8027
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Country | US
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Telephone | 724-850-8118
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Fax | 724-850-9500
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Provider Business Mailing Address
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Address Line | 5 NEWMEYER LN
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City | VANDERBILT
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State | PA
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Zip | 15486-1169
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Country | US
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Telephone | 724-366-0099
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW014929
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License Number State | PA
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