Provider Demographics
NPI:1639166010
Name:PICKERINE, DONALD L (LP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:PICKERINE
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 REEDSDALE ST
Mailing Address - Street 2:MERCY BEHAVIORAL HEALTH
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233-2109
Mailing Address - Country:US
Mailing Address - Phone:412-323-4543
Mailing Address - Fax:412-323-4507
Practice Address - Street 1:9983 PERRY HWY
Practice Address - Street 2:MERCY BEHAVIORAL HEALTH
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9297
Practice Address - Country:US
Practice Address - Phone:724-933-8200
Practice Address - Fax:724-935-8716
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006021L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA277376OtherHIGHMARK
S14049Medicare UPIN
PA770062Medicare ID - Type Unspecified