Healthcare Provider Details

I. General information

NPI: 1184084899
Provider Name (Legal Business Name): KERI SPAW MS, NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 MONROEVILLE BLVD
MONROEVILLE PA
15146
US

IV. Provider business mailing address

4105 MONROEVILLE BLVD
MONROEVILLE PA
15146-2607
US

V. Phone/Fax

Practice location:
  • Phone: 412-380-0100
  • Fax: 412-380-0200
Mailing address:
  • Phone: 412-380-0100
  • Fax: 412-380-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberPC008848
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008848
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: