MEDICARE: JESSICA HASKINS 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	CW016378	PA

General Provider Information

NPI Number	:	1770804502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA HASKINS LCSW

Provider Business Mailing Address
First Line	:	1671 HILLSDALE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-1856
Country	:	US
Telephone Number	:	412-216-2491
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 POTOMAC AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2135
Country	:	US
Telephone Number	:	412-216-2491
Fax Number	:

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

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	11/22/2016

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