Provider Demographics
NPI:1932620861
Name:MARASTI-GEORG, STEPHANIE (MS, PSYD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MARASTI-GEORG
Suffix:
Gender:F
Credentials:MS, PSYD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:GELETKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:68 WABASH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-5435
Mailing Address - Country:US
Mailing Address - Phone:412-455-6890
Mailing Address - Fax:
Practice Address - Street 1:68 WABASH ST STE 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-5435
Practice Address - Country:US
Practice Address - Phone:412-455-6890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional