Organization
EMBODY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER COSTELLO LCSW (OWNDER/LCSW)
(412) 312-6035
Entity
Organization
Contact information
Practice address
1725 WASHINGTON RD STE 602, PITTSBURGH, PA 15241-1215
(412) 312-6035
Mailing address
675 VALLEYVIEW RD, PITTSBURGH, PA 15243-1015
(412) 312-6035
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659798205
—
PA
Enumeration date
12/20/2023
Last updated
12/20/2023
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