Provider Demographics
NPI:1295369114
Name:TATE, MAURI M (LSW)
Entity Type:Individual
Prefix:MRS
First Name:MAURI
Middle Name:M
Last Name:TATE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 NEW HOPE DR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3013
Mailing Address - Country:US
Mailing Address - Phone:814-790-8327
Mailing Address - Fax:
Practice Address - Street 1:363 VANADIUM RD STE 105P
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1477
Practice Address - Country:US
Practice Address - Phone:412-368-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-29
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0239581041C0700X
PASW1323911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical