Provider Demographics
NPI:1891056230
Name:PIZZICO, RANDI ANNE (MA LPC)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:ANNE
Last Name:PIZZICO
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W 6TH AVE
Mailing Address - Street 2:FORREST AVE. ENTRANCE
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1654
Mailing Address - Country:US
Mailing Address - Phone:267-761-2071
Mailing Address - Fax:
Practice Address - Street 1:20 W 6TH AVE
Practice Address - Street 2:FORREST AVE. ENTRANCE
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1654
Practice Address - Country:US
Practice Address - Phone:267-761-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005530101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional