Provider Demographics
NPI:1124304076
Name:DEAN, DAVID J III (MSW, LSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:DEAN
Suffix:III
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-4415
Mailing Address - Country:US
Mailing Address - Phone:724-923-6124
Mailing Address - Fax:724-434-7889
Practice Address - Street 1:1301 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-4415
Practice Address - Country:US
Practice Address - Phone:724-730-3505
Practice Address - Fax:724-434-7889
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130380104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA373695Medicare PIN