Provider Demographics
NPI:1821149204
Name:NADIK, MARILYN ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:ANN
Last Name:NADIK
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 1:10 HERITAGE CT
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-1585
Mailing Address - Country:US
Mailing Address - Phone:724-468-0047
Mailing Address - Fax:
Practice Address - Street 1:2750 GOLDEN MILE HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-2451
Practice Address - Country:US
Practice Address - Phone:412-216-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0151321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA099272Medicare ID - Type Unspecified