Healthcare Provider Details

I. General information

NPI: 1174016901
Provider Name (Legal Business Name): CRYSTAL FIUMARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRYSTAL NORCOTT

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 WASHINGTON RD STE 201
MC MURRAY PA
15317-2952
US

IV. Provider business mailing address

2021 JACOB ST
PITTSBURGH PA
15226-1927
US

V. Phone/Fax

Practice location:
  • Phone: 412-439-1416
  • Fax:
Mailing address:
  • Phone: 412-381-1533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC009119
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: