Healthcare Provider Details

I. General information

NPI: 1992840169
Provider Name (Legal Business Name): PRESSLEY RIDGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 FOREST ST
DOVER DE
19904-3418
US

IV. Provider business mailing address

530 MARSHALL AVE
PITTSBURGH PA
15214-3016
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-1590
  • Fax: 302-677-1591
Mailing address:
  • Phone: 412-321-6995
  • Fax: 412-321-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number517754
License Number StateDE

VIII. Authorized Official

Name: MS. BETH BLAIR
Title or Position: SENIOR ACCOUNTING MANAGER
Credential:
Phone: 412-321-6995