Provider Demographics
NPI:1659617892
Name:MASTRUSERIO, MINDY M (MS, NCC, LPC, CCTPII)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:M
Last Name:MASTRUSERIO
Suffix:
Gender:F
Credentials:MS, NCC, LPC, CCTPII
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:M
Other - Last Name:DONATELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1051 BRINTON RD STE 301D
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-4571
Mailing Address - Country:US
Mailing Address - Phone:412-702-9936
Mailing Address - Fax:412-702-9936
Practice Address - Street 1:1051 BRINTON RD STE 301D
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4571
Practice Address - Country:US
Practice Address - Phone:412-702-9936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC009357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health