Healthcare Provider Details

I. General information

NPI: 1114512431
Provider Name (Legal Business Name): TARO LUKE SEKIKAWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BELLEFIELD AVE STE 6
PITTSBURGH PA
15213-2600
US

IV. Provider business mailing address

100 N BELLEFIELD AVE STE 6
PITTSBURGH PA
15213-2600
US

V. Phone/Fax

Practice location:
  • Phone: 412-246-5619
  • Fax:
Mailing address:
  • Phone: 412-559-9670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: