Healthcare Provider Details

I. General information

NPI: 1588600480
Provider Name (Legal Business Name): SOUTHWESTERN FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5167 BUTLER ST
PITTSBURGH PA
15201-2606
US

IV. Provider business mailing address

110 FORT COUCH RD
PITTSBURGH PA
15241-1030
US

V. Phone/Fax

Practice location:
  • Phone: 412-781-3990
  • Fax: 412-781-3966
Mailing address:
  • Phone: 412-831-1223
  • Fax: 412-831-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE SCHOLLAERT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 412-831-1223