Provider Demographics
NPI:1346609120
Name:BERAN, ALYCIA JEAN (M ED)
Entity Type:Individual
Prefix:MRS
First Name:ALYCIA
Middle Name:JEAN
Last Name:BERAN
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:MS
Other - First Name:ALYCIA
Other - Middle Name:JEAN
Other - Last Name:STORINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4933 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1119
Mailing Address - Country:US
Mailing Address - Phone:412-480-0215
Mailing Address - Fax:
Practice Address - Street 1:4933 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-1119
Practice Address - Country:US
Practice Address - Phone:412-480-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008024101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional