Provider Demographics
NPI:1477563450
Name:HENSCHKE, PERRY GUSTAV (PHD)
Entity Type:Individual
Prefix:
First Name:PERRY
Middle Name:GUSTAV
Last Name:HENSCHKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 EVERGREEN LN
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1060
Mailing Address - Country:US
Mailing Address - Phone:412-749-9050
Mailing Address - Fax:
Practice Address - Street 1:4609 WINTHROP ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3700
Practice Address - Country:US
Practice Address - Phone:412-681-1422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009229L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical