Provider Demographics
NPI:1720580871
Name:BIANCO, CAMDEN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CAMDEN
Middle Name:
Last Name:BIANCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:CAMDEN
Other - Middle Name:
Other - Last Name:ST. CLAIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2147 FAIRLAND ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-4017
Mailing Address - Country:US
Mailing Address - Phone:412-689-0680
Mailing Address - Fax:
Practice Address - Street 1:4729 ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2802
Practice Address - Country:US
Practice Address - Phone:412-621-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PALP009998101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional