Healthcare Provider Details

I. General information

NPI: 1730614355
Provider Name (Legal Business Name): NICHOLAS BRADFORD URAM PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 01/22/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 ALLEQUIPPA ST
PITTSBURGH PA
15240
US

IV. Provider business mailing address

4100 ALLEQUIPPA ST
PITTSBURGH PA
15240
US

V. Phone/Fax

Practice location:
  • Phone: 412-360-6000
  • Fax:
Mailing address:
  • Phone: 412-378-2392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS019571
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: