Provider Demographics
NPI:1487020988
Name:SHUBA, RACHEL MARIE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:SHUBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 OLD POND RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1270
Mailing Address - Country:US
Mailing Address - Phone:412-220-7323
Mailing Address - Fax:412-220-7325
Practice Address - Street 1:300 OLD POND RD STE 201
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1270
Practice Address - Country:US
Practice Address - Phone:412-220-7323
Practice Address - Fax:412-220-7325
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional