Healthcare Provider Details

I. General information

NPI: 1093676082
Provider Name (Legal Business Name): LIVED EXPERIENCE PEER SUPPORT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 SPRINGWOOD DR
VERONA PA
15147-2626
US

IV. Provider business mailing address

538 SPRINGWOOD DR 7436 MCCLURE AVENUE SWISSVALE, PA. 15218
VERONA PA
15147-2626
US

V. Phone/Fax

Practice location:
  • Phone: 412-525-0339
  • Fax: 412-525-0339
Mailing address:
  • Phone: 412-525-0339
  • Fax: 412-525-0339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. ALLAN EDWARD TERRY
Title or Position: FOUNDER & EXECUTIVE DIRECTOR
Credential: CRS/CPS
Phone: 412-525-0339