Provider Demographics
NPI:1245268358
Name:BEATTY, MARY JANE (LMFT)
Entity type:Individual
Prefix:MISS
First Name:MARY JANE
Middle Name:
Last Name:BEATTY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 BABCOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2713
Mailing Address - Country:US
Mailing Address - Phone:412-366-1300
Mailing Address - Fax:412-366-1333
Practice Address - Street 1:802 MCKNIGHT PARK DR
Practice Address - Street 2:SUITE 802
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6504
Practice Address - Country:US
Practice Address - Phone:412-366-1300
Practice Address - Fax:412-366-1333
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000096101Y00000X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional