Provider Demographics
NPI:1689143620
Name:EDLER, NATHAN T (LCSW)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:T
Last Name:EDLER
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 1:311 ROUSER RD
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-6801
Mailing Address - Country:US
Mailing Address - Phone:412-604-8900
Mailing Address - Fax:412-299-8755
Practice Address - Street 1:1360 OLD FREEPORT RD STE 3A&3B
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-4102
Practice Address - Country:US
Practice Address - Phone:412-963-7077
Practice Address - Fax:412-963-7083
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0194581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical