Provider Demographics
NPI:1134385990
Name:REVA HORN COUNSELING & CARE MANAGEMENT INC
Entity type:Organization
Organization Name:REVA HORN COUNSELING & CARE MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REVA
Authorized Official - Middle Name:W
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-422-1430
Mailing Address - Street 1:2204 MURRAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217
Mailing Address - Country:US
Mailing Address - Phone:412-422-1430
Mailing Address - Fax:412-422-1430
Practice Address - Street 1:2204 MURRAY AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217
Practice Address - Country:US
Practice Address - Phone:412-422-1430
Practice Address - Fax:412-422-1430
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REVA HORN COUNSELING & CARE MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
PACW012022104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019592620001Medicaid
PA642829Medicare UPIN