Healthcare Provider Details

I. General information

NPI: 1437380425
Provider Name (Legal Business Name): ALICIA JOY LOGUE LPC, NCC, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 MCKNIGHT RD # 1129
PITTSBURGH PA
15237-3423
US

IV. Provider business mailing address

4801 MCKNIGHT RD # 1129
PITTSBURGH PA
15237-3423
US

V. Phone/Fax

Practice location:
  • Phone: 412-342-8424
  • Fax:
Mailing address:
  • Phone: 412-212-6953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005207
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-08-4188
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: