1073950457 NPI number — MRS. DEANNA ELIZABETH SIKORA LPC

Table of content: MRS. DEANNA ELIZABETH SIKORA LPC (NPI 1073950457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073950457 NPI number — MRS. DEANNA ELIZABETH SIKORA LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIKORA
Provider First Name:
DEANNA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PHILLIPS
Provider Other First Name:
DEANNA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1073950457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 ROBERTS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRINDSTONE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15442-2104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-785-4346
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 ROBERTS RD
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
GRINDSTONE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15442-1105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-915-4714
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2013

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: 101YP2500X , with the licence number:  PC006958 , 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)





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