Provider Demographics
NPI:1184164717
Name:MILLIRON, ELYSE ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELYSE
Middle Name:ANN
Last Name:MILLIRON
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 1:37 MCMURRAY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1632
Mailing Address - Country:US
Mailing Address - Phone:412-583-8968
Mailing Address - Fax:
Practice Address - Street 1:37 MCMURRAY RD STE 102
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1632
Practice Address - Country:US
Practice Address - Phone:412-583-8968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0193341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW019334OtherLCSW LICENSE
PACW019334OtherLICENSE