MEDICARE: MARA KROTEC BAGINSKI 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	CW017644	PA

General Provider Information

NPI Number	:	1881087393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARA KROTEC BAGINSKI LCSW

Provider Business Mailing Address
First Line	:	630 FOXHURST RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-1826
Country	:	US
Telephone Number	:	412-303-1928
Fax Number	:

Provider Business Practice Location Address
First Line	:	1376 FREEPORT RD STE 3A
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-3110
Country	:	US
Telephone Number	:	412-303-1928
Fax Number	:

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

Provider Enumeration Date	:	03/08/2015
Last Update Date	:	12/16/2019

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