Provider Demographics
NPI:1437106424
Name:SMALL, STEFANIE GAIL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:GAIL
Last Name:SMALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:STEFANIE
Other - Middle Name:GAIL
Other - Last Name:STRAUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5743 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1515
Mailing Address - Country:US
Mailing Address - Phone:412-422-7200
Mailing Address - Fax:412-422-9540
Practice Address - Street 1:5743 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1515
Practice Address - Country:US
Practice Address - Phone:412-422-7200
Practice Address - Fax:412-422-9540
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0149101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical