Healthcare Provider Details

I. General information

NPI: 1700704863
Provider Name (Legal Business Name): MANTON BAILIE BA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HOT METAL ST
PITTSBURGH PA
15203-2348
US

IV. Provider business mailing address

2 HOT METAL ST
PITTSBURGH PA
15203-2348
US

V. Phone/Fax

Practice location:
  • Phone: 724-541-8495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: