Healthcare Provider Details

I. General information

NPI: 1487105425
Provider Name (Legal Business Name): REBECCA COMO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA SHUCOSKY LCSW

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4516 BROWNS HILL RD
PITTSBURGH PA
15217
US

IV. Provider business mailing address

4516 BROWNS HILL RD
PITTSBURGH PA
15217-2917
US

V. Phone/Fax

Practice location:
  • Phone: 412-422-7442
  • Fax: 412-904-5025
Mailing address:
  • Phone: 412-422-7442
  • Fax: 412-904-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW019041
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: