Provider Demographics
NPI:1528244209
Name:SEVER, SUE ELLEN (MED, NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:SUE
Middle Name:ELLEN
Last Name:SEVER
Suffix:
Gender:F
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:ELLEN
Other - Last Name:SEVER COHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, NCC, MED
Mailing Address - Street 1:114 OVERTON LN
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2590
Mailing Address - Country:US
Mailing Address - Phone:412-378-9966
Mailing Address - Fax:
Practice Address - Street 1:2550 MOSSIDE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3532
Practice Address - Country:US
Practice Address - Phone:412-373-3471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-13
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004709101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SE2022520OtherKEYSTONE HEALTH PLAN WEST