Provider Demographics
NPI:1467607499
Name:FLOURNOY, MARCUS ANDRETTI (MSW, LSW)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:ANDRETTI
Last Name:FLOURNOY
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 CENTRE AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4305
Mailing Address - Country:US
Mailing Address - Phone:412-261-2298
Mailing Address - Fax:412-471-7837
Practice Address - Street 1:1835 CENTRE AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4305
Practice Address - Country:US
Practice Address - Phone:412-261-2298
Practice Address - Fax:412-471-7837
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health