Provider Demographics
NPI:1124319371
Name:SEDLOCK, REBEKAH A (MSW,LSW)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:A
Last Name:SEDLOCK
Suffix:
Gender:F
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 1:355 5TH AVE
Mailing Address - Street 2:SUITE 1120
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-2409
Mailing Address - Country:US
Mailing Address - Phone:412-434-6700
Mailing Address - Fax:412-434-6710
Practice Address - Street 1:355 5TH AVE
Practice Address - Street 2:SUITE 1120
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2409
Practice Address - Country:US
Practice Address - Phone:412-434-6700
Practice Address - Fax:412-434-6710
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW127808104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker