Provider Demographics
NPI:1598756439
Name:BURTT, CAROLYN STEELE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:STEELE
Last Name:BURTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 MOSSIDE BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146
Mailing Address - Country:US
Mailing Address - Phone:412-373-3471
Mailing Address - Fax:412-373-7324
Practice Address - Street 1:2550 MOSSIDE BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-373-3471
Practice Address - Fax:412-373-7324
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013919104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA074987Medicare ID - Type Unspecified