Provider Demographics
NPI:1720502644
Name:SORRELL, MARYANN MARGARET (LSW)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:MARGARET
Last Name:SORRELL
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 1:2944 WEST LIBERTY AVENUE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2944 W LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HILLS
Practice Address - State:PA
Practice Address - Zip Code:15216-2526
Practice Address - Country:US
Practice Address - Phone:412-341-8326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW003270E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker