Provider Demographics
NPI:1558596817
Name:JODY BECHTOLD, LCSW, LLC
Entity Type:Organization
Organization Name:JODY BECHTOLD, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECHTOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-303-0163
Mailing Address - Street 1:2641 PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2048
Mailing Address - Country:US
Mailing Address - Phone:412-303-0163
Mailing Address - Fax:
Practice Address - Street 1:20 CEDAR BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1330
Practice Address - Country:US
Practice Address - Phone:412-303-0163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0154861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW015486OtherLCSW
PA1104982412OtherINDIVIDUAL NPI