Provider Demographics
NPI:1023033990
Name:HERDT, SYLVIA V (LCSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:V
Last Name:HERDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 AMBASSADOR LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:PA
Mailing Address - Zip Code:16059-1457
Mailing Address - Country:US
Mailing Address - Phone:724-272-1984
Mailing Address - Fax:153-082-0619
Practice Address - Street 1:2591 WEXFORD BAYNE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8676
Practice Address - Country:US
Practice Address - Phone:724-272-1984
Practice Address - Fax:153-082-0619
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA631569OtherHIGHMARK
202856OtherUPMC
PA673053OtherBLUE CROSS BLUE SHIELD PA
873505Medicare UPIN
PA631569OtherHIGHMARK
PA673053Medicare PIN