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General NPI Number Information
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NPI Number | 1588995724
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Entity Type | Individual
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Provider Name | MALLORY BEATTY LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 3811 OHARA ST
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City | PITTSBURGH
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State | PA
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Zip | 15213-2593
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Country | US
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Telephone | 412-331-2887
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Fax |
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Provider Business Mailing Address
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Address Line | 500 MCKNIGHT PARK DR STE 502A
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City | PITTSBURGH
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State | PA
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Zip | 15237-6517
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Country | US
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Telephone | 412-499-3477
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Fax | 412-253-9269
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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 | SW127339
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License Number State | PA
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