MEDICARE: SUZANNA RAE STYLES 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
1	1041C0700X	Clinical Social Worker	CW020444	PA

General Provider Information

NPI Number	:	1396308623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNA RAE STYLES LCSW

Provider Business Mailing Address
First Line	:	1100 S BRADDOCK AVE STE 3
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1238
Country	:	US
Telephone Number	:	412-540-5022
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 S BRADDOCK AVE STE 3
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1238
Country	:	US
Telephone Number	:	412-540-5022
Fax Number	:

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

Provider Enumeration Date	:	04/22/2019
Last Update Date	:	03/07/2024

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