Provider Demographics
NPI:1780620732
Name:HOOVER, WAYNE ANTHONY (PHD)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:ANTHONY
Last Name:HOOVER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3208
Mailing Address - Country:US
Mailing Address - Phone:412-781-9487
Mailing Address - Fax:412-782-6860
Practice Address - Street 1:122 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3208
Practice Address - Country:US
Practice Address - Phone:412-782-3510
Practice Address - Fax:412-782-6860
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS0087562103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00171015330001Medicaid
1545921OtherBCBS
S61709Medicare UPIN
PA013547TRVMedicare ID - Type Unspecified