Provider Demographics
NPI:1659362598
Name:EISENGART, STACIE ANNE (MSCD NCC LPC)
Entity Type:Individual
Prefix:MS
First Name:STACIE
Middle Name:ANNE
Last Name:EISENGART
Suffix:
Gender:F
Credentials:MSCD NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2550 MOSSIDE BLVD
Mailing Address - Street 2:STE 304
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3540
Mailing Address - Country:US
Mailing Address - Phone:412-373-3471
Mailing Address - Fax:412-373-7324
Practice Address - Street 1:2550 MOSSIDE BLVD
Practice Address - Street 2:STE 304
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3540
Practice Address - Country:US
Practice Address - Phone:412-373-3471
Practice Address - Fax:412-373-7324
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPC003363101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01886540Medicaid
PA01886540Medicaid
Q24190Medicare UPIN