Provider Demographics
NPI:1356527220
Name:IRWIN, SARAH RYAN RYDELL (MA, LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RYAN RYDELL
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 BANKSVILLE RD
Mailing Address - Street 2:FAMILYLINKS
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-2812
Mailing Address - Country:US
Mailing Address - Phone:412-661-1800
Mailing Address - Fax:412-924-0259
Practice Address - Street 1:2644 BANKSVILLE RD
Practice Address - Street 2:FAMILYLINKS
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2812
Practice Address - Country:US
Practice Address - Phone:412-661-1800
Practice Address - Fax:412-924-0259
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60172924101YM0800X
PAPC006876101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health