Provider Demographics
NPI:1164209474
Name:MOUNTAIN TRAIL COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:MOUNTAIN TRAIL COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:412-886-3629
Mailing Address - Street 1:1438 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-2004
Mailing Address - Country:US
Mailing Address - Phone:412-886-3629
Mailing Address - Fax:
Practice Address - Street 1:6 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-2497
Practice Address - Country:US
Practice Address - Phone:412-227-9019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty