Provider Demographics
NPI: | 1295265536 |
---|---|
Name: | STEEL VALLEY WELLNESS GROUP, LLC |
Entity type: | Organization |
Organization Name: | STEEL VALLEY WELLNESS GROUP, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CO-OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KATIE |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | HRUSKA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 412-855-8058 |
Mailing Address - Street 1: | 1803 WEST ST |
Mailing Address - Street 2: | |
Mailing Address - City: | HOMESTEAD |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15120-2572 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 412-368-3535 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1803 WEST ST |
Practice Address - Street 2: | |
Practice Address - City: | HOMESTEAD |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15120 |
Practice Address - Country: | US |
Practice Address - Phone: | 412-368-3535 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-06-19 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | PC008830 | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |