1932497336 NPI number — STAY COUNSELING CENTER, LLC

Table of content: (NPI 1932497336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932497336 NPI number — STAY COUNSELING CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STAY COUNSELING CENTER, 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:
1932497336
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
470 STREETS RUN RD
Provider Second Line Business Mailing Address:
SUITE 402
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15236-2023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-653-7829
Provider Business Mailing Address Fax Number:
412-653-7828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
470 STREETS RUN RD
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15236-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-653-7829
Provider Business Practice Location Address Fax Number:
412-653-7828
Provider Enumeration Date:
07/19/2011

Additional Information

Authorized Official

Authorized Official Last Name:
STAY
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER/THERAPIST
Authorized Official Telephone Number:
412-653-7829

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW14580 , 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)

  • Identifier: 342143 . This is a "MNH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 11625443 . This is a "CQHQ" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 556099 . This is a "HIGHMARK BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000075977 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 296292000 . This is a "MAGELLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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