Provider Demographics
NPI:1073873105
Name:FAST, REBECCA (MSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FAST
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214-3320
Mailing Address - Country:US
Mailing Address - Phone:412-605-0749
Mailing Address - Fax:
Practice Address - Street 1:2409 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15214-3320
Practice Address - Country:US
Practice Address - Phone:412-605-0749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1292461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical