MEDICARE: JOANNE V. CROUGH COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1336756717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOANNE V. CROUGH COUNSELING, LLC

Provider Business Mailing Address
First Line	:	475 JEFFERSON DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-2165
Country	:	US
Telephone Number	:	412-999-8736
Fax Number	:

Provider Business Practice Location Address
First Line	:	475 JEFFERSON DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-2165
Country	:	US
Telephone Number	:	412-465-0754
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JOANNE V. CROUGH
Credential	:	LPC
Telephone Number	:	412-999-8736

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	09/29/2020

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