Healthcare Provider Details

I. General information

NPI: 1083654818
Provider Name (Legal Business Name): ALYSIA D. KIRK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2884 INDUSTRIAL BLVD STE 2
BETHEL PARK PA
15102-2580
US

IV. Provider business mailing address

1999 RIDGE RD
SOUTH PARK PA
15129-8802
US

V. Phone/Fax

Practice location:
  • Phone: 412-254-3183
  • Fax:
Mailing address:
  • Phone: 412-721-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014835
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: