Provider Demographics
NPI:1609039957
Name:EUGENE
Entity Type:Organization
Organization Name:EUGENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEVICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:412-343-1225
Mailing Address - Street 1:260 MORRISON DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1242
Mailing Address - Country:US
Mailing Address - Phone:412-343-1225
Mailing Address - Fax:412-343-1225
Practice Address - Street 1:260 MORRISON DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-1242
Practice Address - Country:US
Practice Address - Phone:412-343-1225
Practice Address - Fax:412-343-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS001439L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty