Provider Demographics
NPI:1255458980
Name:ALBERT, JACQUELYN MILLER (LCSW)
Entity type:Individual
Prefix:MS
First Name:JACQUELYN
Middle Name:MILLER
Last Name:ALBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OLIVER ROAD, OLIVER SQUARE, SUITE 116
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2376
Mailing Address - Country:US
Mailing Address - Phone:724-438-4960
Mailing Address - Fax:
Practice Address - Street 1:78 MORGANTOWN ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4239
Practice Address - Country:US
Practice Address - Phone:724-439-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0128961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical