MEDICARE: MRS. CAMDEN BIANCO LPC

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	LP009998	PA

General Provider Information

NPI Number	:	1720580871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAMDEN BIANCO LPC

Provider Business Mailing Address
First Line	:	2147 FAIRLAND ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15210-4017
Country	:	US
Telephone Number	:	412-689-0680
Fax Number	:

Provider Business Practice Location Address
First Line	:	4729 ELLSWORTH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-2802
Country	:	US
Telephone Number	:	412-621-4361
Fax Number	:

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

Provider Enumeration Date	:	03/05/2018
Last Update Date	:	03/05/2018

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