Provider Demographics
NPI:1922563253
Name:FULLER-TRIPODI, CAROLINE (M ED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:FULLER-TRIPODI
Suffix:
Gender:F
Credentials:M ED, LPC, NCC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:M ED, LPC, NCC
Mailing Address - Street 1:1824 MURRAY AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1655
Mailing Address - Country:US
Mailing Address - Phone:412-589-8770
Mailing Address - Fax:
Practice Address - Street 1:1824 MURRAY AVE STE 304
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1655
Practice Address - Country:US
Practice Address - Phone:412-589-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC010799OtherLPC