Provider Demographics
NPI:1396178372
Name:ZUPANCIC, EMILY BERTHA (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BERTHA
Last Name:ZUPANCIC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:BERTHA
Other - Last Name:STUBNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:123 DEER VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9502
Mailing Address - Country:US
Mailing Address - Phone:412-302-3902
Mailing Address - Fax:
Practice Address - Street 1:123 DEER VALLEY DR
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9502
Practice Address - Country:US
Practice Address - Phone:412-302-3902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0172121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical