MEDICARE: REBECCA BRISKI MA, LPC, CADC

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	PC010142	PA

General Provider Information

NPI Number	:	1407319536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA BRISKI MA, LPC, CADC

Provider Business Mailing Address
First Line	:	110 BOSTWICK DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15229-1401
Country	:	US
Telephone Number	:	724-831-6679
Fax Number	:

Provider Business Practice Location Address
First Line	:	20530 ROUTE 19 STE 4
Second Line	:
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066-7518
Country	:	US
Telephone Number	:	724-831-6679
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2019
Last Update Date	:	04/06/2019

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