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NPI Code Detail

MEDICARE: MRS. JENNIFER ANN MACIOCE LCSW

MEDICARE: MRS. JENNIFER ANN MACIOCE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW012598PA

General Provider Information

NPI Number : 1124062591
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER ANN MACIOCE LCSW
Provider Business Mailing Address
First Line : 12820 DEBORAH DR
Second Line :
City : NORTH HUNTINGDON
State : PA
Zip : 15642-2860
Country : US
Telephone Number : 724-515-5388
Fax Number :
Provider Business Practice Location Address
First Line : 712 SOUTH AVE
Second Line : ALLEGHENY EAST MH/MR CENTER, INC
City : PITTSBURGH
State : PA
Zip : 15221-2940
Country : US
Telephone Number : 412-473-8059
Fax Number : 412-731-5025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 07/08/2007

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