Healthcare Provider Details

I. General information

NPI: 1093044646
Provider Name (Legal Business Name): MOUNT ARARAT BAPTIST CHURCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 PAULSON AVE
PITTSBURGH PA
15206-3270
US

IV. Provider business mailing address

271 PAULSON AVE
PITTSBURGH PA
15206-3270
US

V. Phone/Fax

Practice location:
  • Phone: 412-441-1800
  • Fax: 412-441-5406
Mailing address:
  • Phone: 412-441-1800
  • Fax: 412-441-5406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004362
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW006827L
License Number StatePA

VIII. Authorized Official

Name: DR. TAUNYA MARIE TINSLEY
Title or Position: DIRECTOR
Credential: PH.D., NCC, LPC
Phone: 412-441-1800