Healthcare Provider Details

I. General information

NPI: 1174517148
Provider Name (Legal Business Name): ALLIANCE HEALTH WRAPAROUND ALLEGHENY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 BROWN AVE
TURTLE CREEK PA
15145-1137
US

IV. Provider business mailing address

635 BROWN AVE
TURTLE CREEK PA
15145-1137
US

V. Phone/Fax

Practice location:
  • Phone: 412-823-5293
  • Fax: 412-823-5294
Mailing address:
  • Phone: 412-823-5293
  • Fax: 412-823-5294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS000524L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. KRISTY TOME
Title or Position: BILLING MANAGER
Credential:
Phone: 412-823-5293