Provider Demographics
NPI:1629219209
Name:SAYUT, GLORIA JEAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:JEAN
Last Name:SAYUT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 PINE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-1362
Mailing Address - Country:US
Mailing Address - Phone:412-973-3234
Mailing Address - Fax:
Practice Address - Street 1:1580 MCLAUGHLIN RUN RD STE 203B
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3100
Practice Address - Country:US
Practice Address - Phone:412-973-3234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2017-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional