Provider Demographics
NPI:1104203983
Name:WYATT, AKIRAH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AKIRAH
Middle Name:
Last Name:WYATT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AKIRAH
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 43RD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-3139
Mailing Address - Country:US
Mailing Address - Phone:412-849-5929
Mailing Address - Fax:
Practice Address - Street 1:1101 EDGAR ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2862
Practice Address - Country:US
Practice Address - Phone:717-851-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131347101YP2500X
PACW0199241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional