Healthcare Provider Details

I. General information

NPI: 1902793326
Provider Name (Legal Business Name): DIVERSE MINDS PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 OLD WILLIAM PENN HWY STE 206
MONROEVILLE PA
15146-1480
US

IV. Provider business mailing address

4175 IVANHOE DR APT 215
MONROEVILLE PA
15146-2622
US

V. Phone/Fax

Practice location:
  • Phone: 412-998-8274
  • Fax:
Mailing address:
  • Phone: 847-544-9521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: UNSA MEMON
Title or Position: OWNER
Credential: LPC
Phone: 847-544-9521