Provider Demographics
NPI:1306616982
Name:DESTEFANO, JULIEHERA (MSW LSW)
Entity type:Individual
Prefix:
First Name:JULIEHERA
Middle Name:
Last Name:DESTEFANO
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 1:420 DUKE CT
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-7803
Mailing Address - Country:US
Mailing Address - Phone:917-692-3036
Mailing Address - Fax:
Practice Address - Street 1:809 BINGHAM ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1009
Practice Address - Country:US
Practice Address - Phone:412-380-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140530104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker