Provider Demographics
NPI:1528635414
Name:GANN, PATRICK (LSW)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:GANN
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 1:7243 PRINCETON PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-2038
Mailing Address - Country:US
Mailing Address - Phone:717-309-1530
Mailing Address - Fax:
Practice Address - Street 1:6507 WILKINS AVE STE 103
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1305
Practice Address - Country:US
Practice Address - Phone:717-309-1530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0239311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical