Provider Demographics
NPI:1629165444
Name:BOND, MICHAEL ANTHONY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:BOND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 OHIO RIVER BLVD
Mailing Address - Street 2:G 07
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1358
Mailing Address - Country:US
Mailing Address - Phone:412-908-0668
Mailing Address - Fax:
Practice Address - Street 1:111 HAZEL LANE
Practice Address - Street 2:SUITE 300
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1253
Practice Address - Country:US
Practice Address - Phone:412-749-7333
Practice Address - Fax:412-749-7339
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW012825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA589206GZUMedicare PIN