Provider Demographics
NPI:1285078303
Name:MARUGG, STEPHANIE K (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:K
Last Name:MARUGG
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 1:3755 E STATE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3410
Mailing Address - Country:US
Mailing Address - Phone:724-503-6678
Mailing Address - Fax:
Practice Address - Street 1:3755 E STATE ST STE 6
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3410
Practice Address - Country:US
Practice Address - Phone:724-503-6678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0192951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103005550Medicaid