Provider Demographics
NPI:1114400488
Name:LARUSSA, VICTORIA DEY
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:DEY
Last Name:LARUSSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 JAMESTOWN PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4944
Mailing Address - Country:US
Mailing Address - Phone:412-526-1978
Mailing Address - Fax:
Practice Address - Street 1:712 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2940
Practice Address - Country:US
Practice Address - Phone:412-243-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health