Provider Demographics
NPI:1720212137
Name:WEIDNER, KRISTY JOY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:JOY
Last Name:WEIDNER
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 1:68 WABASH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-5435
Mailing Address - Country:US
Mailing Address - Phone:412-952-9151
Mailing Address - Fax:
Practice Address - Street 1:68 WABASH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-5435
Practice Address - Country:US
Practice Address - Phone:412-952-9151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0161951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical