Provider Demographics
NPI:1124008594
Name:ROOT, STEPHEN L (MSSW, ACSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:L
Last Name:ROOT
Suffix:
Gender:M
Credentials:MSSW, ACSW, LCSW
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:ROOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSSW,ACSW, LCSW
Mailing Address - Street 1:2250 MARY ST
Mailing Address - Street 2:UNIT 201
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2287
Mailing Address - Country:US
Mailing Address - Phone:412-496-2272
Mailing Address - Fax:412-431-2123
Practice Address - Street 1:5743 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1515
Practice Address - Country:US
Practice Address - Phone:412-521-3800
Practice Address - Fax:412-422-1162
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2012-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO134361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical