1194296772 NPI number — LAURA BETH RAUSCH LCSW

Table of content: MR. NOEL J SHIMA (NPI 1831384106)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194296772 NPI number — LAURA BETH RAUSCH LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAUSCH
Provider First Name:
LAURA
Provider Middle Name:
BETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FAUBLE
Provider Other First Name:
LAURA
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1194296772
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8045 HINSDALE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC DONALD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15057-3576
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-716-2398
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 HIGH TOWER BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15205-1135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-823-5155
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/08/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW019834 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)