Provider Demographics
NPI:1881926442
Name:CRIBBS, SHANNON WILSON (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:WILSON
Last Name:CRIBBS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3792 LOGANS FERRY RD APT D
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-3913
Mailing Address - Country:US
Mailing Address - Phone:412-303-9416
Mailing Address - Fax:
Practice Address - Street 1:615 WASHINGTON RD
Practice Address - Street 2:SUITE 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1901
Practice Address - Country:US
Practice Address - Phone:412-343-6416
Practice Address - Fax:412-343-6418
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005423101YP2500X
PAPA017708103T00000X, 103G00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling