Healthcare Provider Details
I. General information
NPI: 1669173795
Provider Name (Legal Business Name): KATEY DYANNE THIRY PMHNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/15/2023
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5250 CASTE DR
PITTSBURGH PA
15236-1502
US
IV. Provider business mailing address
6000 WATERDAM PLAZA DR
CANONSBURG PA
15317-5413
US
V. Phone/Fax
- Phone: 412-885-7017
- Fax:
- Phone: 412-923-6070
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| License Number | RN664424 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | SP028772 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: