Provider Demographics
NPI:1376252403
Name:POSITIVE DIRECTIONS PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:POSITIVE DIRECTIONS PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:BANE
Authorized Official - Last Name:TILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:412-378-1058
Mailing Address - Street 1:3337 ROUTE 130 STE 2
Mailing Address - Street 2:
Mailing Address - City:HARRISON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15636-1260
Mailing Address - Country:US
Mailing Address - Phone:518-244-3737
Mailing Address - Fax:
Practice Address - Street 1:3337 ROUTE 130 STE 2
Practice Address - Street 2:
Practice Address - City:HARRISON CITY
Practice Address - State:PA
Practice Address - Zip Code:15636-1260
Practice Address - Country:US
Practice Address - Phone:412-378-1058
Practice Address - Fax:412-324-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty