MEDICARE: KIMBERLY WEDNER 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
1	1041C0700X	Clinical Social Worker	CW027279	PA
2	1041C0700X	Clinical Social Worker	32086	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01536011	OTHER	CA	MEDI-CAL
2	CW027279	OTHER	PA	CLINICAL SOCIAL WORK

General Provider Information

NPI Number	:	1861808792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY WEDNER MSW

Provider Business Mailing Address
First Line	:	363 VANADIUM RD STE 105
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15243-1477
Country	:	US
Telephone Number	:	412-368-2211
Fax Number	:	412-279-1418

Provider Business Practice Location Address
First Line	:	5830 ELLSWORTH AVE FL 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1778
Country	:	US
Telephone Number	:	412-368-2211
Fax Number	:	412-279-1418

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

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	04/07/2026

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Directions to “ KIMBERLY WEDNER MSW” Practice Location

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