Healthcare Provider Details

I. General information

NPI: 1619097615
Provider Name (Legal Business Name): DOUGLAS SCHILLER PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4716 ELLSWORTH AVE SUITE 211
PITTSBURGH PA
15213-2851
US

IV. Provider business mailing address

4716 ELLSWORTH AVE SUITE 211
PITTSBURGH PA
15213-2851
US

V. Phone/Fax

Practice location:
  • Phone: 412-682-5655
  • Fax:
Mailing address:
  • Phone: 412-682-5655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS-004743
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: