Provider Demographics
NPI:1912177007
Name:COLEMAN, REBECCA STEVENS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:STEVENS
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:STEVENS
Other - Last Name:RUSTINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1013 WESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-1384
Mailing Address - Country:US
Mailing Address - Phone:772-766-4441
Mailing Address - Fax:412-205-3839
Practice Address - Street 1:5115 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1301
Practice Address - Country:US
Practice Address - Phone:412-647-2811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6528103T00000X
PAPS171510103T00000X
PAPS017150103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPS171510OtherPA LICENSE
FLPY6528OtherFLORIDA LICENSE