Healthcare Provider Details

I. General information

NPI: 1164980751
Provider Name (Legal Business Name): CGM PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 01/06/2024
Certification Date: 01/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 TERMINAL WAY STE 525A
PITTSBURGH PA
15219-1216
US

IV. Provider business mailing address

306 4TH AVE APT 901
PITTSBURGH PA
15222-2008
US

V. Phone/Fax

Practice location:
  • Phone: 724-299-1848
  • Fax:
Mailing address:
  • Phone: 908-797-7981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHELSEA NICOLE GREFE MCCANN
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 908-797-7981