=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932545126
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GINA BOBICH LEO M.ED., LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2013
-----------------------------------------------------
Last Update Date | 05/15/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1201 S BRADDOCK AVE STE 2
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15218-1275
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-241-8552
-----------------------------------------------------
Fax | 412-241-8479
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1201 S BRADDOCK AVE THE CENTER FOR COUNSELING ARTS
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15218-1275
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-241-8552
-----------------------------------------------------
Fax | 412-241-8479
-----------------------------------------------------
=====================================================
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 | PC006713
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------