Provider Demographics
NPI:1730288770
Name:GECKLE, MICHELLE OLIVIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:OLIVIA
Last Name:GECKLE
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 1:1037 LINDENDALE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1935
Mailing Address - Country:US
Mailing Address - Phone:412-344-6119
Mailing Address - Fax:
Practice Address - Street 1:5000 MCKNIGHT RD STE 207
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3428
Practice Address - Country:US
Practice Address - Phone:412-367-1481
Practice Address - Fax:412-635-3012
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002188101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor