Provider Demographics
NPI:1972362820
Name:BROSSEAU, PAT PETER (LSW)
Entity type:Individual
Prefix:
First Name:PAT
Middle Name:PETER
Last Name:BROSSEAU
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 S TRENTON AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3143
Mailing Address - Country:US
Mailing Address - Phone:860-682-2622
Mailing Address - Fax:
Practice Address - Street 1:411 S TRENTON AVE APT 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3143
Practice Address - Country:US
Practice Address - Phone:860-682-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141250104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker