Provider Demographics
NPI:1619272341
Name:STAJNRAJH, CARISSA R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARISSA
Middle Name:R
Last Name:STAJNRAJH
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 1:1701 ROYAL OAK DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1015
Mailing Address - Country:US
Mailing Address - Phone:724-322-1073
Mailing Address - Fax:
Practice Address - Street 1:1701 ROYAL OAK DR APT 2A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1015
Practice Address - Country:US
Practice Address - Phone:724-322-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0168431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical