Provider Demographics
NPI:1992154546
Name:MCMILLAN, NANCY (LSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TAYLOR WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1856
Mailing Address - Country:US
Mailing Address - Phone:412-914-8487
Mailing Address - Fax:412-914-8475
Practice Address - Street 1:600 TAYLOR WAY STE 201
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1856
Practice Address - Country:US
Practice Address - Phone:412-914-8487
Practice Address - Fax:412-914-8475
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012293L101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker