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NPI Code Detail

MEDICARE: GEORGE E DALZELL LCSW

MEDICARE: GEORGE E DALZELL 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
1101YA0400XAddiction (Substance Use Disorder) CounselorCW015639PA
21041C0700XClinical Social WorkerCW015639PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CW015639OTHERPASTATE LICENSE

General Provider Information

NPI Number : 1720262058
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE E DALZELL LCSW
Provider Business Mailing Address
First Line : 5150 PENN AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15224-1626
Country : US
Telephone Number : 412-441-9786
Fax Number : 412-363-2375
Provider Business Practice Location Address
First Line : 5150 PENN AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15224-1626
Country : US
Telephone Number : 412-441-9786
Fax Number : 412-363-2375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2007
Last Update Date : 10/10/2022

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Directions to “ GEORGE E DALZELL LCSW” Practice Location

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