Provider Demographics
NPI:1003161712
Name:KASSOUF, PAULA SUE (MSPC)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:SUE
Last Name:KASSOUF
Suffix:
Gender:F
Credentials:MSPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1973 PITTVIEW AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-1353
Mailing Address - Country:US
Mailing Address - Phone:412-260-8230
Mailing Address - Fax:
Practice Address - Street 1:401 SHADY AVE STE B105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4458
Practice Address - Country:US
Practice Address - Phone:412-695-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional