Provider Demographics
NPI:1336239573
Name:STAY, SUSAN M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:STAY
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 1:470 STREETS RUN RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-2023
Mailing Address - Country:US
Mailing Address - Phone:412-653-7829
Mailing Address - Fax:412-653-7828
Practice Address - Street 1:470 STREETS RUN RD
Practice Address - Street 2:SUITE 402
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-2023
Practice Address - Country:US
Practice Address - Phone:412-653-7829
Practice Address - Fax:412-653-7828
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2015-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW145801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA342143OtherMNH
PA11625443OtherCQHQ
PA296292000OtherMAGELLAN
PA556099OtherHIGHMARK BC/BS
PA556099OtherHIGHMARK BC/BS