Provider Demographics
NPI:1770008203
Name:OSUAGWU, THADDEUS UCHENNA (LCSW)
Entity Type:Individual
Prefix:
First Name:THADDEUS
Middle Name:UCHENNA
Last Name:OSUAGWU
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 1:217 CONSTITUTION AVE
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-1938
Mailing Address - Country:US
Mailing Address - Phone:1443-221-1201
Mailing Address - Fax:
Practice Address - Street 1:109 WHITAKER ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-2411
Practice Address - Country:US
Practice Address - Phone:412-482-4540
Practice Address - Fax:412-301-1868
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-05
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12407203-35011041C0700X
OHI.22035431041C0700X
PACW0226301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical