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NPI Code Detail

MEDICARE: ALEXIS WALDECK MSW

MEDICARE: ALEXIS WALDECK MSW
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 Worker

General Provider Information

NPI Number : 1528777992
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS WALDECK MSW
Provider Business Mailing Address
First Line : 630 MARYLAND AVE APT 2B
Second Line :
City : PITTSBURGH
State : PA
Zip : 15232-1737
Country : US
Telephone Number : 267-339-1816
Fax Number :
Provider Business Practice Location Address
First Line : 2400 E CARSON ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15203-2191
Country : US
Telephone Number : 412-694-6242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2022
Last Update Date : 11/15/2022

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