Healthcare Provider Details

I. General information

NPI: 1750978086
Provider Name (Legal Business Name): RESILIENT YOU COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MAPLE DR STE A
WEXFORD PA
15090-8327
US

IV. Provider business mailing address

147 THREE DEGREE RD
PITTSBURGH PA
15237-2305
US

V. Phone/Fax

Practice location:
  • Phone: 412-537-9343
  • Fax:
Mailing address:
  • Phone: 412-537-9343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: JENNY KUZILLA
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 412-537-9343