MEDICARE: MS. SARA A KICHTA M.ED. COUNSELING

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	PC006087	PA

General Provider Information

NPI Number	:	1427466481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARA A KICHTA M.ED. COUNSELING

Provider Business Mailing Address
First Line	:	2414 COBDEN ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2712
Country	:	US
Telephone Number	:	412-337-9719
Fax Number	:

Provider Business Practice Location Address
First Line	:	2414 COBDEN ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2712
Country	:	US
Telephone Number	:	412-337-9719
Fax Number	:

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

Provider Enumeration Date	:	07/23/2014
Last Update Date	:	07/23/2014

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