1124464441 NPI number — DR. NICKOLAS SUMMA LMFT

Table of content: DR. NICKOLAS SUMMA LMFT (NPI 1124464441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124464441 NPI number — DR. NICKOLAS SUMMA LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUMMA
Provider First Name:
NICKOLAS
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
M

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:
1124464441
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 ROBBINS STATION RD STE 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRWIN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15642-2037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-238-7274
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
907 WEST ST STE 516
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221-2838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-238-7274
Provider Business Practice Location Address Fax Number:
412-345-5827
Provider Enumeration Date:
05/14/2013

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:  PC017052 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: MF000917 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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