Provider Demographics
NPI:1952456147
Name:WESLEY SPECTRUM SERVICES
Entity Type:Organization
Organization Name:WESLEY SPECTRUM SERVICES
Other - Org Name:THE WESLEY INSTITUE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:412-831-9390
Mailing Address - Street 1:243 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SAINT CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2534
Mailing Address - Country:US
Mailing Address - Phone:412-831-9390
Mailing Address - Fax:412-831-8868
Practice Address - Street 1:221 PENN AVE
Practice Address - Street 2:
Practice Address - City:WILKINSBURG
Practice Address - State:PA
Practice Address - Zip Code:15221-2118
Practice Address - Country:US
Practice Address - Phone:412-831-9390
Practice Address - Fax:412-831-9390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA422740101YM0800X, 106H00000X, 261QM0801X
PA422580251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001340160016Medicaid
PA329484A042016OtherVBH OF PA