Healthcare Provider Details

I. General information

NPI: 1134038979
Provider Name (Legal Business Name): ARCHETYPAL COUNSELING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CEDAR BLVD STE 207
PITTSBURGH PA
15228-1330
US

IV. Provider business mailing address

401 SHADY AVE STE B205-1
PITTSBURGH PA
15206-4409
US

V. Phone/Fax

Practice location:
  • Phone: 412-512-3756
  • Fax: 412-365-5963
Mailing address:
  • Phone: 412-512-3756
  • Fax: 412-365-5963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUGLAS C STEWART
Title or Position: OWNER
Credential: MS, LPC
Phone: 412-512-3756