Healthcare Provider Details
I. General information
NPI: 1205753746
Provider Name (Legal Business Name): AKESO THERAPEUTICS & WELLNESS COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
448 WYLIE AVE
CLAIRTON PA
15025-1415
US
IV. Provider business mailing address
3202 MCKNIGHT EAST DR # 382
PITTSBURGH PA
15237-6423
US
V. Phone/Fax
- Phone: 412-440-7601
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERICA
CONNER-VAN BUREN
Title or Position: MANAGING MEMBER
Credential: LPC, NCC
Phone: 412-440-7601