Provider Demographics
NPI:1073620597
Name:EDGAR, MARJORIE HALL (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:HALL
Last Name:EDGAR
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 1:40 HUFF AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5318
Mailing Address - Country:US
Mailing Address - Phone:724-836-4662
Mailing Address - Fax:724-836-2876
Practice Address - Street 1:40 HUFF AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5318
Practice Address - Country:US
Practice Address - Phone:724-836-4662
Practice Address - Fax:724-836-2876
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0146441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical