Provider Demographics
NPI:1376985580
Name:WASSERMAN-LUX, JOHANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:
Last Name:WASSERMAN-LUX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GILA
Other - Middle Name:
Other - Last Name:WASSERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:114 LANG CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2752
Mailing Address - Country:US
Mailing Address - Phone:917-974-7706
Mailing Address - Fax:
Practice Address - Street 1:114 LANG CT
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-2752
Practice Address - Country:US
Practice Address - Phone:917-974-7706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0177791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical