Provider Demographics
NPI:1578337135
Name:EXISTENTIAL-DYNAMIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:EXISTENTIAL-DYNAMIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SOMOVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-901-9913
Mailing Address - Street 1:19 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1306
Mailing Address - Country:US
Mailing Address - Phone:412-901-9913
Mailing Address - Fax:
Practice Address - Street 1:160 N CRAIG ST STE 104
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2717
Practice Address - Country:US
Practice Address - Phone:412-901-9913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty