Provider Demographics
NPI:1649814229
Name:MISTICK, CATHERINE V (MS)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:V
Last Name:MISTICK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:V
Other - Last Name:MISTICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1932 BEECHWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1704
Mailing Address - Country:US
Mailing Address - Phone:412-290-1750
Mailing Address - Fax:
Practice Address - Street 1:6315 FORBES AVE STE B016
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1700
Practice Address - Country:US
Practice Address - Phone:412-290-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015491101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health