Provider Demographics
NPI:1750637401
Name:SOUSA, JAMIE LYNNE (LMHC, CTRS-BH, CYFI)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYNNE
Last Name:SOUSA
Suffix:
Gender:F
Credentials:LMHC, CTRS-BH, CYFI
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:LYNNE
Other - Last Name:WARGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9400 MCKNIGHT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6007
Mailing Address - Country:US
Mailing Address - Phone:412-721-6999
Mailing Address - Fax:
Practice Address - Street 1:9400 MCKNIGHT RD STE 201
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6007
Practice Address - Country:US
Practice Address - Phone:412-721-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17585101YM0800X
PAPC013633101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health