Provider Demographics
NPI:1245803964
Name:ADSCENSIO PSYCHOLOGY TELEHEALTH LLC
Entity Type:Organization
Organization Name:ADSCENSIO PSYCHOLOGY TELEHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:724-866-0741
Mailing Address - Street 1:319 STAMBAUGH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-4123
Mailing Address - Country:US
Mailing Address - Phone:412-407-2654
Mailing Address - Fax:
Practice Address - Street 1:319 STAMBAUGH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-4123
Practice Address - Country:US
Practice Address - Phone:412-407-2654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty