Provider Demographics
NPI:1881136067
Name:MARK MINDER LCSW
Entity type:Organization
Organization Name:MARK MINDER LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MINDER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-636-7509
Mailing Address - Street 1:319 S LANG AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2749
Mailing Address - Country:US
Mailing Address - Phone:412-636-7509
Mailing Address - Fax:
Practice Address - Street 1:319 S LANG AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-2749
Practice Address - Country:US
Practice Address - Phone:412-636-7509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-05
Last Update Date:2016-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW019031251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health