Provider Demographics
NPI:1790365013
Name:HARRISON, STEPHANIE (LP)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 WASHINGTON PIKE STE 303
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2886
Mailing Address - Country:US
Mailing Address - Phone:412-641-7016
Mailing Address - Fax:412-622-7595
Practice Address - Street 1:230 N CRAIG ST STE B
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1569
Practice Address - Country:US
Practice Address - Phone:412-621-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1258103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist