Provider Demographics
NPI:1235262452
Name:SARNESE, MARY T (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:SARNESE
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:PO BOX 763
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-0763
Mailing Address - Country:US
Mailing Address - Phone:724-483-4070
Mailing Address - Fax:
Practice Address - Street 1:400 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-1530
Practice Address - Country:US
Practice Address - Phone:724-483-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008031L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASA749042Medicare ID - Type Unspecified