Provider Demographics
NPI:1457656050
Name:PIEMONTE, MICHAEL SANTINO (LSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SANTINO
Last Name:PIEMONTE
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1808
Mailing Address - Country:US
Mailing Address - Phone:814-254-4502
Mailing Address - Fax:
Practice Address - Street 1:417 MAIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1808
Practice Address - Country:US
Practice Address - Phone:814-254-4502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW127164104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker