Provider Demographics
NPI:1699771543
Name:PRETTIMAN, ENID ANN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:ENID
Middle Name:ANN
Last Name:PRETTIMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 TOWER WAY
Mailing Address - Street 2:STE 2034
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5786
Mailing Address - Country:US
Mailing Address - Phone:724-850-8220
Mailing Address - Fax:724-850-8222
Practice Address - Street 1:2000 TOWER WAY
Practice Address - Street 2:STE 2034
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5786
Practice Address - Country:US
Practice Address - Phone:724-850-8220
Practice Address - Fax:724-850-8222
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008503L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA155704OtherVALUE OPTIONS SUBMITTER I
PA884035OtherBLUE CROSS/BLUE SHIELD
PA202622OtherUPMC ID NUMBER