Provider Demographics
NPI:1487679395
Name:BIBRO-RUCH, JULANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JULANNE
Middle Name:
Last Name:BIBRO-RUCH
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 1:377 BROADWAY DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4138
Mailing Address - Country:US
Mailing Address - Phone:412-551-1000
Mailing Address - Fax:
Practice Address - Street 1:1720 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1208
Practice Address - Country:US
Practice Address - Phone:412-854-4887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0158351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW015835OtherSOCIAL WORK