Provider Demographics
NPI:1215401419
Name:FUNK, NATALIE (LSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:FUNK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:FUNK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:125 EMERYVILLE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5020
Mailing Address - Country:US
Mailing Address - Phone:724-609-5002
Mailing Address - Fax:724-299-8964
Practice Address - Street 1:125 EMERYVILLE DR STE 230
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-5020
Practice Address - Country:US
Practice Address - Phone:724-609-5002
Practice Address - Fax:724-299-8964
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135518104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker