Provider Demographics
NPI:1063184000
Name:MCBRIDE, AUTUMN T (MSCP, LPC)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:T
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:MSCP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 PITTSBURGH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:EAST MC KEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15035-1363
Mailing Address - Country:US
Mailing Address - Phone:412-889-6836
Mailing Address - Fax:
Practice Address - Street 1:5840 ELLSWORTH AVE STE 104
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1727
Practice Address - Country:US
Practice Address - Phone:412-628-1326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013740101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional