Provider Demographics
NPI:1508000894
Name:WESTERN PSYCHIATRIC INSTITUTE AND CLINIC
Entity Type:Organization
Organization Name:WESTERN PSYCHIATRIC INSTITUTE AND CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:412-383-1555
Mailing Address - Street 1:373 BURROWS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2201
Mailing Address - Country:US
Mailing Address - Phone:412-383-1575
Mailing Address - Fax:
Practice Address - Street 1:373 BURROWS ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2201
Practice Address - Country:US
Practice Address - Phone:412-383-1575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA424290252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency