Provider Demographics
NPI:1922574177
Name:COLLABORATIVE PSYCHIATRIC SERVICES
Entity Type:Organization
Organization Name:COLLABORATIVE PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MITZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:412-307-5600
Mailing Address - Street 1:4900 PERRY HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-2236
Mailing Address - Country:US
Mailing Address - Phone:412-307-5600
Mailing Address - Fax:412-301-0441
Practice Address - Street 1:4900 PERRY HWY STE 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15229-2236
Practice Address - Country:US
Practice Address - Phone:412-366-0416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty