Provider Demographics
NPI:1083078299
Name:CAMUSO, ALISSIA MARY (LSW)
Entity Type:Individual
Prefix:MS
First Name:ALISSIA
Middle Name:MARY
Last Name:CAMUSO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608C KELLY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3134
Mailing Address - Country:US
Mailing Address - Phone:814-590-4253
Mailing Address - Fax:
Practice Address - Street 1:608C KELLY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3134
Practice Address - Country:US
Practice Address - Phone:814-590-4253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129747104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker