Provider Demographics
NPI:1417077322
Name:BLOCK, SANDRA ALANE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:ALANE
Last Name:BLOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2843 SHADY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2769
Mailing Address - Country:US
Mailing Address - Phone:412-422-4029
Mailing Address - Fax:
Practice Address - Street 1:7500 BROOKTREE RD
Practice Address - Street 2:SUITE 222
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9254
Practice Address - Country:US
Practice Address - Phone:724-935-4040
Practice Address - Fax:724-935-6044
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0129531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical