Provider Demographics
NPI:1609357631
Name:CHURILLA, AUBREE MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AUBREE
Middle Name:MARIE
Last Name:CHURILLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AUBREE
Other - Middle Name:MARIE
Other - Last Name:SMELTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:142 CHRIS DR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-9119
Mailing Address - Country:US
Mailing Address - Phone:412-523-6386
Mailing Address - Fax:
Practice Address - Street 1:339 OLD HAYMAKER RD STE 1102
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1685
Practice Address - Country:US
Practice Address - Phone:412-824-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW018186261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health