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General NPI Number Information
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NPI Number | 1346296191
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Entity Type | Organization
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Legal Business Name | CHERYL MASSIMO LLC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7424 WASHINGTON STREET
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City | PITTSBURGH
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State | PA
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Zip | 15218
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Country | US
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Telephone | 412-818-3509
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17974
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City | PITTSBURGH
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State | PA
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Zip | 15235
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Country | US
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Telephone | 412-818-3509
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Fax |
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Authorized Official
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Title or Position | MEMBER CHERYL MASSIMO LLC
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Name | MS. CHERYL ELIZABETH MASSIMO
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Credential | LCSW
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Telephone | 412-818-3509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015306
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License Number State | PA
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