=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932760378
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARISA FLORO, LCSW
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2019
-----------------------------------------------------
Last Update Date | 05/05/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 540 N NEVILLE ST STE 102
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15213-2853
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-847-5169
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3607 BUTLER ST APT 201
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15201-1871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-847-5169
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST
-----------------------------------------------------
Name | MARISA FLORO
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 412-847-5169
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------