Healthcare Provider Details

I. General information

NPI: 1326070426
Provider Name (Legal Business Name): CYNTHIA ANN LAUSBERG PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 SHADY AVE SUITE C105
PITTSBURGH PA
15206-4409
US

IV. Provider business mailing address

401 SHADY AVE SUITE C105
PITTSBURGH PA
15206-4409
US

V. Phone/Fax

Practice location:
  • Phone: 724-448-1311
  • Fax:
Mailing address:
  • Phone: 724-448-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS015166
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: