1356527220 NPI number — SARAH RYAN RYDELL IRWIN MA, LPC

Table of content: SARAH RYAN RYDELL IRWIN MA, LPC (NPI 1356527220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356527220 NPI number — SARAH RYAN RYDELL IRWIN MA, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IRWIN
Provider First Name:
SARAH
Provider Middle Name:
RYAN RYDELL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, 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:
1356527220
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2644 BANKSVILLE RD
Provider Second Line Business Mailing Address:
FAMILYLINKS
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15216-2812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-661-1800
Provider Business Mailing Address Fax Number:
412-924-0259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2644 BANKSVILLE RD
Provider Second Line Business Practice Location Address:
FAMILYLINKS
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15216-2812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-661-1800
Provider Business Practice Location Address Fax Number:
412-924-0259
Provider Enumeration Date:
01/10/2008

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: 101YM0800X , with the licence number:  LH 60172924 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: PC006876 , 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)