Healthcare Provider Details

I. General information

NPI: 1447555347
Provider Name (Legal Business Name): SUMMIT PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 OLD FREEPORT RD STE 1A
PITTSBURGH PA
15238-3122
US

IV. Provider business mailing address

1350 OLD FREEPORT RD STE 1A
PITTSBURGH PA
15238-3122
US

V. Phone/Fax

Practice location:
  • Phone: 412-406-7734
  • Fax: 412-406-7742
Mailing address:
  • Phone: 412-406-7734
  • Fax: 412-406-7742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. MINDY SEREMBO
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 888-924-3627