Healthcare Provider Details

I. General information

NPI: 1659833689
Provider Name (Legal Business Name): KATYA LEBEDEV DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 OLD NATIONAL PIKE
FREDERICKTOWN PA
15333-2114
US

IV. Provider business mailing address

1904 ROCKLEDGE ST
PITTSBURGH PA
15212-3520
US

V. Phone/Fax

Practice location:
  • Phone: 724-632-6801
  • Fax:
Mailing address:
  • Phone: 678-333-5526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberOS023841
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: