Provider Demographics
NPI:1407920895
Name:CROWLEY LINDSTROM, SANDRA MARIE (LCSW LIC CLIN SOC WK)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIE
Last Name:CROWLEY LINDSTROM
Suffix:
Gender:F
Credentials:LCSW LIC CLIN SOC WK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 WILLIAM PITT WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1361
Mailing Address - Country:US
Mailing Address - Phone:412-820-2050
Mailing Address - Fax:412-820-0259
Practice Address - Street 1:310 CENTRAL CITY PLAZA
Practice Address - Street 2:FSWP
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068
Practice Address - Country:US
Practice Address - Phone:724-335-9883
Practice Address - Fax:724-335-2730
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0123861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA006350FT5Medicare ID - Type Unspecified
S51624Medicare UPIN