Provider Demographics
NPI:1063858827
Name:MCNULTY, CARRIE A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:MCNULTY
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 1:201 PENN CENTER BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5441
Mailing Address - Country:US
Mailing Address - Phone:814-574-4235
Mailing Address - Fax:
Practice Address - Street 1:201 PENN CENTER BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5441
Practice Address - Country:US
Practice Address - Phone:814-574-4235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128763104100000X
PACW0179321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker