1518308261 NPI number — NICOLE THERESA GEMPERLE MS, LPC

Table of content: NICOLE THERESA GEMPERLE MS, LPC (NPI 1518308261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518308261 NPI number — NICOLE THERESA GEMPERLE MS, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEMPERLE
Provider First Name:
NICOLE
Provider Middle Name:
THERESA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518308261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1221 ARKANSAS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15216-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-953-9538
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 NORTHPOINTE CIR
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
SEVEN FIELDS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16046-7851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-772-4848
Provider Business Practice Location Address Fax Number:
724-772-4888
Provider Enumeration Date:
07/10/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  PC005772 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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