Basic Information
| Provider Information | |||||||||
| NPI: | 1487218665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOINS | ||||||||
| FirstName: | CORRISSA | ||||||||
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| Credential: | MS, LPC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 806 BEAVER RD | ||||||||
| Address2: | |||||||||
| City: | AMBRIDGE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150032031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145584724 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 FORT COUCH RD STE 2 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152411030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128311223 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2019 | ||||||||
| LastUpdateDate: | 04/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | PC011272 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.