Healthcare Provider Details

I. General information

NPI: 1477077634
Provider Name (Legal Business Name): JUSTABOUT PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 VALLEY BROOK RD
MC MURRAY PA
15317-3370
US

IV. Provider business mailing address

375 VALLEY BROOK RD STE 101
CANONSBURG PA
15317-3370
US

V. Phone/Fax

Practice location:
  • Phone: 412-389-5810
  • Fax:
Mailing address:
  • Phone: 724-941-4414
  • Fax: 724-941-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier103442232-0001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: DR. BRIAN LIPINSKI
Title or Position: OFFICE MANAGER
Credential:
Phone: 412-660-4808