Provider Demographics
NPI:1790345775
Name:STANDISH, JESSICA RICHARDS (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RICHARDS
Last Name:STANDISH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7469 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-2430
Mailing Address - Country:US
Mailing Address - Phone:412-977-3565
Mailing Address - Fax:
Practice Address - Street 1:202 BEAVER ST FL 3
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1221
Practice Address - Country:US
Practice Address - Phone:412-741-7430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health