Healthcare Provider Details

I. General information

NPI: 1598681033
Provider Name (Legal Business Name): JESSICA WITZLEB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N BRADDOCK AVE
PITTSBURGH PA
15208-2512
US

IV. Provider business mailing address

333 N BRADDOCK AVE
PITTSBURGH PA
15208-2512
US

V. Phone/Fax

Practice location:
  • Phone: 412-864-5004
  • Fax: 412-864-5044
Mailing address:
  • Phone: 412-864-5004
  • Fax: 412-864-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: