Provider Demographics
NPI:1265423230
Name:CLUSS, PATRICIA A (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:CLUSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5889 FORWARD AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2320
Mailing Address - Country:US
Mailing Address - Phone:412-521-7707
Mailing Address - Fax:412-647-4252
Practice Address - Street 1:5889 FORBES AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1660
Practice Address - Country:US
Practice Address - Phone:412-521-7707
Practice Address - Fax:412-647-4252
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004771L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA591672Medicare UPIN