1689923377 NPI number — CATALYST CROSSROADS, LLC

Table of content: (NPI 1689923377)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689923377 NPI number — CATALYST CROSSROADS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATALYST CROSSROADS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1689923377
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
461 COCHRAN RD
Provider Second Line Business Mailing Address:
#140
Provider Business Mailing Address City Name:
MT LEBANON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15228-1253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-969-2733
Provider Business Mailing Address Fax Number:
412-774-2069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 BOWER HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15228-1419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-760-4626
Provider Business Practice Location Address Fax Number:
412-774-2069
Provider Enumeration Date:
09/10/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
412-760-4626

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133NN1002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 172V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 175F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 246Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2400X , with the licence number: PA-2279 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225700000X , with the licence number: MSG00005670 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2400X , with the licence number: PA-2279 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2500X , with the licence number: PA-2279 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1082811775 . This is a "GLC CERTIFICATION BY SPENCER INSTITUTE(GREEN LIVING)" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA-2279 . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: DC0234 . This is a "BOARD CERTIFICATION- DISASTER CRISIS OUTREACH&REFERRAL PROF. (PA CERT. BOARD)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA-2279 . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 70393001 . This is a "BOARD CERTIFICATION AADP (AMERICAN ASSOCIATION OF DRUGLESS PRACTITIONERS)" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA-2279 . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: PA-2279 . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: MSG00005670 . This is a "MASSAGE THERAPY LICENSE THROUGH PITTSBURGH SCHOOL OF MASSAGE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: NP-001070 . This is a "BOARD CERTIFICATION AIP (ASSOCIATION FOR INTEGRATIVE PSYCHOLOGY)" identifier . This identifiers is of the category "OTHER".
  • Identifier: AL011937 . This is a "UNION CERTIFICATION BY HYPNOTHERAPISTS LOCAL NO. 472" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA-2279 . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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