MEDICARE: MRS. COURTNEY EVELYN PUGLIA LSW

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
1	104100000X	Social Worker	S2512550	OH

General Provider Information

NPI Number	:	1215882311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY EVELYN PUGLIA LSW

Provider Business Mailing Address
First Line	:	57 E POTTSVILLE ST
Second Line	:
City	:	PINE GROVE
State	:	PA
Zip	:	17963-1523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 E POTTSVILLE ST
Second Line	:
City	:	PINE GROVE
State	:	PA
Zip	:	17963-1523
Country	:	US
Telephone Number	:	216-798-1781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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