Healthcare Provider Details

I. General information

NPI: 1568972735
Provider Name (Legal Business Name): TERRI FESSLER LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 10/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6315 FORBES AVE STE F114B
PITTSBURGH PA
15217-1745
US

IV. Provider business mailing address

6315 FORBES AVE STE F114B
PITTSBURGH PA
15217-1745
US

V. Phone/Fax

Practice location:
  • Phone: 412-417-3401
  • Fax:
Mailing address:
  • Phone: 412-417-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberCW015901
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberCW015901
License Number StatePA

VIII. Authorized Official

Name: TERRI L. FESSLER
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 412-417-3401