Healthcare Provider Details

I. General information

NPI: 1710497151
Provider Name (Legal Business Name): ALICIA SEWALD-CISNEROS MA, LPC, CCTP, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8235 OHIO RIVER BLVD
PITTSBURGH PA
15202-1454
US

IV. Provider business mailing address

8235 OHIO RIVER BLVD
PITTSBURGH PA
15202-1454
US

V. Phone/Fax

Practice location:
  • Phone: 412-766-4030
  • Fax: 412-766-4030
Mailing address:
  • Phone: 412-766-4030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC01258
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: