Provider Demographics
NPI:1457691420
Name:DOVE, MICHELLE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:DOVE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:MIKELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:30 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15223-1761
Mailing Address - Country:US
Mailing Address - Phone:412-608-3755
Mailing Address - Fax:
Practice Address - Street 1:105 BRAUNLICH DR STE 210
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-367-9800
Practice Address - Fax:412-369-9800
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0189831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW018983OtherPENNSYLVANIA DEPARTMENT OF STATE