Provider Demographics
NPI:1093955916
Name:WPIC OF UPMC PRESBYTERIAN SHADYSIDE
Entity Type:Organization
Organization Name:WPIC OF UPMC PRESBYTERIAN SHADYSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOBKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-586-9335
Mailing Address - Street 1:3811 OHARA ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2593
Mailing Address - Country:US
Mailing Address - Phone:412-586-9335
Mailing Address - Fax:412-246-5200
Practice Address - Street 1:3811 OHARA ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2593
Practice Address - Country:US
Practice Address - Phone:412-586-9335
Practice Address - Fax:412-246-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW012923283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000666005OtherHIGHMARK