Healthcare Provider Details

I. General information

NPI: 1831573450
Provider Name (Legal Business Name): LAUREN M BYLSMA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BELLEFIELD AVE
PITTSBURGH PA
15213-2600
US

IV. Provider business mailing address

3811 OHARA ST
PITTSBURGH PA
15213-2561
US

V. Phone/Fax

Practice location:
  • Phone: 412-624-8363
  • Fax:
Mailing address:
  • Phone: 412-624-8363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS017868
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: