Provider Demographics
NPI:1952646879
Name:CENTER FOR VICTIMS
Entity Type:Organization
Organization Name:CENTER FOR VICTIMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-482-3240
Mailing Address - Street 1:410 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-4028
Mailing Address - Country:US
Mailing Address - Phone:412-664-7146
Mailing Address - Fax:412-482-3241
Practice Address - Street 1:5916 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3846
Practice Address - Country:US
Practice Address - Phone:412-482-3240
Practice Address - Fax:412-482-3241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129611104100000X
PASW127700104100000X
PASW011232L104100000X
PACW0142121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty