MEDICARE: HEIDI PEBLER LEIBOVICH LCSW

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	CW016032	PA
2	1041C0700X	Clinical Social Worker	CW016032	PA

General Provider Information

NPI Number	:	1619123007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI PEBLER LEIBOVICH LCSW

Provider Business Mailing Address
First Line	:	1016 GREENTREE RD
Second Line	:	SUITE 102
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-3100
Country	:	US
Telephone Number	:	412-561-0411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 GREENTREE RD
Second Line	:	SUITE 102
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-3100
Country	:	US
Telephone Number	:	412-937-0411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	05/28/2015

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Directions to “ HEIDI PEBLER LEIBOVICH LCSW” Practice Location

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