Provider Demographics
NPI:1265191647
Name:SULECKI, LAUREN MARIE (LSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:SULECKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15209-2719
Mailing Address - Country:US
Mailing Address - Phone:814-882-7373
Mailing Address - Fax:
Practice Address - Street 1:6301 FORBES AVE STE 120
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1725
Practice Address - Country:US
Practice Address - Phone:412-212-8443
Practice Address - Fax:215-249-6206
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132598104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker