Provider Demographics
NPI:1346834538
Name:PEACE LOVE WHOLENESS, LLC
Entity Type:Organization
Organization Name:PEACE LOVE WHOLENESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-879-0336
Mailing Address - Street 1:4406 VISTAVIEW ST
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-2143
Mailing Address - Country:US
Mailing Address - Phone:412-983-1863
Mailing Address - Fax:
Practice Address - Street 1:4406 VISTAVIEW ST
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2143
Practice Address - Country:US
Practice Address - Phone:412-879-0336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-27
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty