Provider Demographics
NPI:1992840169
Name:PRESSLEY RIDGE
Entity Type:Organization
Organization Name:PRESSLEY RIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ACCOUNTING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-321-6995
Mailing Address - Street 1:530 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214-3016
Mailing Address - Country:US
Mailing Address - Phone:412-321-6995
Mailing Address - Fax:412-321-7008
Practice Address - Street 1:870 FOREST ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3418
Practice Address - Country:US
Practice Address - Phone:302-677-1590
Practice Address - Fax:302-677-1591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TP2701X
DE517754251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000023576Medicaid