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NPI Code Detail

MEDICARE: WESLEY SPECTRUM SERVICES

MEDICARE: WESLEY SPECTRUM SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor422720PA
2101YS0200XSchool Counselor422720PA
3251300000XLocal Education Agency (LEA)422720PA
4261QM0855XAdolescent and Children Mental Health Clinic/Center422720PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2329484A847396OTHERPAVBH OF PA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972658144
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESLEY SPECTRUM SERVICES
Provider Business Mailing Address
First Line : 243 JOHNSTON RD
Second Line :
City : UPPER SAINT CLAIR
State : PA
Zip : 15241-2534
Country : US
Telephone Number : 412-831-9390
Fax Number : 412-831-8868
Provider Business Practice Location Address
First Line : 5250 CASTE DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15236-1502
Country : US
Telephone Number : 412-831-9390
Fax Number : 412-831-8868
Authorized Official
Title or Position : CEO
Name : DOUG MUETZEL
Credential :
Telephone Number : 412-831-9390
Provider Enumeration Date : 01/25/2007
Last Update Date : 05/21/2008

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Directions to “WESLEY SPECTRUM SERVICES ” Practice Location

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