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Individual

EMMA BEDFORD-JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LICSW

Contact information

Practice address
211 N WHITFIELD ST, PITTSBURGH, PA 15206-3039
(412) 283-6767
Mailing address
211 N WHITFIELD ST, PITTSBURGH, PA 15206-3039

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW021093
PA
1041C0700X
Clinical Social Worker
LICSW127559
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CW021093
LICENSED CLINICAL SOCIAL WORKER
PA
01
LICSW127559
LICENSED INDEPENDENT CLINICAL SOCIAL WORKER
MA
Enumeration date
08/10/2017
Last updated
05/22/2024
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