Provider Demographics
NPI:1215370226
Name:COCO, MICHELLE CARMELLA (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CARMELLA
Last Name:COCO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1852
Mailing Address - Country:US
Mailing Address - Phone:412-431-5665
Mailing Address - Fax:412-431-0913
Practice Address - Street 1:81 S 19TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1852
Practice Address - Country:US
Practice Address - Phone:412-431-5665
Practice Address - Fax:412-431-0913
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical