1427244235 NPI number — PSYCHOTHERAPY ASSOCIATES, INC.

Table of content: (NPI 1427244235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427244235 NPI number — PSYCHOTHERAPY ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PSYCHOTHERAPY ASSOCIATES, INC.
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:
1427244235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 ASHWOOD DR STE 1201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANONSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-4982
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-884-0466
Provider Business Mailing Address Fax Number:
724-649-0039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 ASHWOOD DR STE 1201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANONSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-4982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-884-0466
Provider Business Practice Location Address Fax Number:
724-228-3943
Provider Enumeration Date:
09/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HEIM
Authorized Official First Name:
EMILY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
724-884-0466

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 62474378 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5448648 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 93655 . This is a "TRICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942926 . This is a "HIGHMARK BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 102553200-0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11613707 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 120060 . This is a "VALUE OPTIONS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2668179 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 395502 . This is a "MHN" identifier . This identifiers is of the category "OTHER".




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