Provider Demographics
NPI:1609177807
Name:MOOREHEAD, PATRICIA ANN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:MOOREHEAD
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:COMEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:125 EMERYVILLE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5020
Mailing Address - Country:US
Mailing Address - Phone:724-609-5002
Mailing Address - Fax:724-299-8964
Practice Address - Street 1:125 EMERYVILLE DR STE 230
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-5020
Practice Address - Country:US
Practice Address - Phone:724-609-5002
Practice Address - Fax:724-299-8964
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD176851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD609550002Medicaid
MD517251OtherOPTUM
MD259147-000OtherMAGELLAN HEALTH CARE
MDR968OtherCAREFIRST GHMSI & REGIONAL PPN
MD522156095OtherCOMMERCIAL INS
MDLM49EAOtherCAREFIRST BCBS
MD7840093OtherAETNA
MD609500300Medicaid
MD346646OtherMHN
MDLM49EAOtherCAREFIRST BCBS