Provider Demographics
NPI:1124039441
Name:AVANT, BRIAN (LSW)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:AVANT
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 PINE WAY
Mailing Address - Street 2:
Mailing Address - City:BRADDOCK
Mailing Address - State:PA
Mailing Address - Zip Code:15104-1826
Mailing Address - Country:US
Mailing Address - Phone:412-271-0643
Mailing Address - Fax:412-365-4468
Practice Address - Street 1:7180 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1206
Practice Address - Country:US
Practice Address - Phone:412-365-5734
Practice Address - Fax:412-365-4468
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker