MEDICARE: CHILD FAMILY & COMMUNITY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	PC004308	PA

General Provider Information

NPI Number	:	1366596694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILD FAMILY & COMMUNITY INC.

Provider Business Mailing Address
First Line	:	300 MOUNT LEBANON BLVD
Second Line	:	SUITE 301-B
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1512
Country	:	US
Telephone Number	:	412-343-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 MOUNT LEBANON BLVD
Second Line	:	SUITE 301-B
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1512
Country	:	US
Telephone Number	:	412-343-2000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BONITA MCNALLY-BROWN
Credential	:	LPC
Telephone Number	:	412-343-2000

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

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