Provider Demographics
NPI:1669521829
Name:MCCLELLAN, MARGOT WEISS (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARGOT
Middle Name:WEISS
Last Name:MCCLELLAN
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 1:117 DEER VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9502
Mailing Address - Country:US
Mailing Address - Phone:412-741-1163
Mailing Address - Fax:
Practice Address - Street 1:117 DEER VALLEY DR
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9502
Practice Address - Country:US
Practice Address - Phone:412-741-1163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0151841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW015184OtherSTATE LICENSE