Provider Demographics
NPI:1629318225
Name:DAQUELENTE, ERIN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:DAQUELENTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RUTLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-1920
Mailing Address - Country:US
Mailing Address - Phone:412-600-1226
Mailing Address - Fax:412-781-5362
Practice Address - Street 1:1326 FREEPORT RD
Practice Address - Street 2:SUITE 325
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3131
Practice Address - Country:US
Practice Address - Phone:412-219-4743
Practice Address - Fax:412-781-5362
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-SW128097104100000X
PACW0178881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker