Provider Demographics
NPI:1376884114
Name:WALDRUP, WESLEY F (LPC)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:F
Last Name:WALDRUP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 OLD FREEPORT RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3122
Mailing Address - Country:US
Mailing Address - Phone:412-406-7734
Mailing Address - Fax:
Practice Address - Street 1:1350 OLD FREEPORT RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3122
Practice Address - Country:US
Practice Address - Phone:412-406-7734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001350-1101YM0800X
PAPC006688101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health