Provider Demographics
NPI:1770579823
Name:BEDNAREK, DONNA M (PHD, LICENSED PSYCH)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:BEDNAREK
Suffix:
Gender:F
Credentials:PHD, LICENSED PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1523
Mailing Address - Country:US
Mailing Address - Phone:412-741-4087
Mailing Address - Fax:412-741-6808
Practice Address - Street 1:424 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1523
Practice Address - Country:US
Practice Address - Phone:412-741-4087
Practice Address - Fax:412-741-6808
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004994L103TB0200X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA243331A189092Medicaid
PA0015858500001Medicaid
PA202716OtherWBH (UPMC COMMERCIAL)
PA243331OtherVALUE OPTIONS COMMERCIAL
PA068127OtherBLUE CROSS BLUE SHIELD