Provider Demographics
NPI:1821177106
Name:SHAUL, JOEL DALE (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:DALE
Last Name:SHAUL
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CAMPMEETING RD
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8773
Mailing Address - Country:US
Mailing Address - Phone:412-749-2879
Mailing Address - Fax:412-741-1958
Practice Address - Street 1:301 CAMPMEETING RD
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8773
Practice Address - Country:US
Practice Address - Phone:412-479-2879
Practice Address - Fax:412-741-1958
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO147151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P90162Medicare UPIN
083352Medicare ID - Type Unspecified