Healthcare Provider Details

I. General information

NPI: 1679536221
Provider Name (Legal Business Name): ASSOCIATES IN CLINICAL PSYCHIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 FORT COUCH RD SUITE G200
PITTSBURGH PA
15241-1030
US

IV. Provider business mailing address

110 FORT COUCH RD SUITE G200
PITTSBURGH PA
15241-1030
US

V. Phone/Fax

Practice location:
  • Phone: 412-347-0170
  • Fax: 412-347-0174
Mailing address:
  • Phone: 412-347-0170
  • Fax: 412-347-0174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW130203
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRUCE ALAN WRIGHT
Title or Position: PRESIDENT
Credential: MD
Phone: 412-347-0170