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General NPI Number Information
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NPI Number | 1679541759
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Entity Type | Individual
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Provider Name | THOMAS M. LANDRY LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | PITTSBURGH PASTORAL INSTITUTE 6324 MARCHAND ST
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City | PITTSBURGH
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State | PA
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Zip | 15206
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Country | US
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Telephone | 412-661-1239
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 E END AVE
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City | PITTSBURGH
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State | PA
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Zip | 15218-1309
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Country | US
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Telephone | 412-371-1501
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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 | CW000398L
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License Number State | PA
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