Provider Demographics
NPI:1144000506
Name:KUSTURISS, MICAH CHRISTIAN (MS)
Entity type:Individual
Prefix:MR
First Name:MICAH
Middle Name:CHRISTIAN
Last Name:KUSTURISS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BALDWICK RD STE 280
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-4160
Mailing Address - Country:US
Mailing Address - Phone:412-922-4300
Mailing Address - Fax:
Practice Address - Street 1:2500 BALDWICK RD STE 280
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4160
Practice Address - Country:US
Practice Address - Phone:412-922-4300
Practice Address - Fax:412-922-4301
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health