Provider Demographics
NPI:1891728242
Name:MCCONNELL, ELIZABETH (BETSY) M (MSW,LICSW,BCD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH (BETSY)
Middle Name:M
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:MSW,LICSW,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BAUM BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3793
Mailing Address - Country:US
Mailing Address - Phone:412-871-3438
Mailing Address - Fax:
Practice Address - Street 1:5750 BAUM BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206
Practice Address - Country:US
Practice Address - Phone:412-362-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0001130751041C0700X
PACW0176091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000113075OtherLICENSE NUMBER LICSW
PACW017609OtherPA LICENSE IN CLINICAL SOCIAL SOCIAL WORK
MAPO8562OtherBLUE CROSS