=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689908741
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FORTUNA FRENCH MAAT, ATR-BC, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2009
-----------------------------------------------------
Last Update Date | 09/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1011 BINGHAM ST
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15203-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-427-0563
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 265 ROYCROFT AVE
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15234-1244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-427-0563
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | PC002977
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------