Healthcare Provider Details

I. General information

NPI: 1770179962
Provider Name (Legal Business Name): JONATHAN WEINGARDEN PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2020
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 LOOP ST STE 3
PITTSBURGH PA
15215-3248
US

IV. Provider business mailing address

6 LOOP ST STE 3
PITTSBURGH PA
15215-3248
US

V. Phone/Fax

Practice location:
  • Phone: 412-240-5686
  • Fax:
Mailing address:
  • Phone: 412-240-5686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS018517
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS018517
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS018517
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPS018517
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS018517
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: