Provider Demographics
NPI:1124598743
Name:WAITKUS, MONICA (LCSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:WAITKUS
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 1:25 CHARTIERS AVE
Mailing Address - Street 2:
Mailing Address - City:RANKIN
Mailing Address - State:PA
Mailing Address - Zip Code:15104
Mailing Address - Country:US
Mailing Address - Phone:304-657-4711
Mailing Address - Fax:
Practice Address - Street 1:344 DUQUESNE WAY
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143
Practice Address - Country:US
Practice Address - Phone:412-330-1361
Practice Address - Fax:888-339-0756
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0201511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1912353194OtherHEATHER NARAYAN