Provider Demographics
NPI:1790009421
Name:WJS PSYCHOLOGICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:WJS PSYCHOLOGICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-430-0555
Mailing Address - Street 1:99 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4236
Mailing Address - Country:US
Mailing Address - Phone:724-430-0555
Mailing Address - Fax:724-430-0966
Practice Address - Street 1:99 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4236
Practice Address - Country:US
Practice Address - Phone:724-430-0555
Practice Address - Fax:724-430-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021428030003Medicaid