Provider Demographics
NPI:1710353016
Name:PITTSBURGH PSYCHIATRIC AND PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:PITTSBURGH PSYCHIATRIC AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-303-3045
Mailing Address - Street 1:215 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-1707
Mailing Address - Country:US
Mailing Address - Phone:517-303-3045
Mailing Address - Fax:412-455-6723
Practice Address - Street 1:2008 MURRAY AVE
Practice Address - Street 2:SUITE A2
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2169
Practice Address - Country:US
Practice Address - Phone:412-278-5000
Practice Address - Fax:412-455-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443748261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)