Provider Demographics
NPI:1366416158
Name:CEBULA, JANE VIRGINIA (LPC)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:VIRGINIA
Last Name:CEBULA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 VICTORY LN
Mailing Address - Street 2:
Mailing Address - City:LEETSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15056-1216
Mailing Address - Country:US
Mailing Address - Phone:412-741-5686
Mailing Address - Fax:
Practice Address - Street 1:409 BROAD ST
Practice Address - Street 2:SUITE 101A
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1557
Practice Address - Country:US
Practice Address - Phone:412-741-5451
Practice Address - Fax:412-741-5452
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003666101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor