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General NPI Number Information
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NPI Number | 1912476045
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Entity Type | Individual
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Provider Name | TARA BETH PANNELL LPC, NBCC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 1301 S BRADDOCK AVE FL 1
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City | PITTSBURGH
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State | PA
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Zip | 15218-1251
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Country | US
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Telephone | 412-425-2530
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Fax |
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Provider Business Mailing Address
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Address Line | 7448 SCHOYER AVE
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City | PITTSBURGH
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State | PA
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Zip | 15218-2316
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Country | US
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Telephone | 412-425-2530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC010896
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License Number State | PA
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