Provider Demographics
NPI:1144026428
Name:MARSICO, LAURA KATHLEEN
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHLEEN
Last Name:MARSICO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 CUSTER AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2103
Mailing Address - Country:US
Mailing Address - Phone:412-463-8405
Mailing Address - Fax:
Practice Address - Street 1:5830 ELLSWORTH AVE STE 301
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1778
Practice Address - Country:US
Practice Address - Phone:571-601-3656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPCO16958101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional