Provider Demographics
NPI:1427466481
Name:KICHTA, SARA A (MED COUNSELING)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:A
Last Name:KICHTA
Suffix:
Gender:F
Credentials:MED COUNSELING
Other - Prefix:MRS
Other - First Name:SARA
Other - Middle Name:K
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:2414 COBDEN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2712
Mailing Address - Country:US
Mailing Address - Phone:412-337-9719
Mailing Address - Fax:
Practice Address - Street 1:2414 COBDEN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2712
Practice Address - Country:US
Practice Address - Phone:412-337-9719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional