Provider Demographics
NPI:1376692137
Name:VOGEL, VIVIAN LEE (LCSW,QCSW)
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:LEE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LCSW,QCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 REITER RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4005
Mailing Address - Country:US
Mailing Address - Phone:412-793-5070
Mailing Address - Fax:
Practice Address - Street 1:1011 OLD SALEM RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1094
Practice Address - Country:US
Practice Address - Phone:724-837-9540
Practice Address - Fax:724-836-3676
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW010211L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical