Healthcare Provider Details

I. General information

NPI: 1285789776
Provider Name (Legal Business Name): WESLEY SPECTRUM SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 W CHESTNUT ST STE 200EW
WASHINGTON PA
15301-4524
US

IV. Provider business mailing address

221 PENN AVE
WILKINSBURG PA
15221-2118
US

V. Phone/Fax

Practice location:
  • Phone: 724-222-7500
  • Fax:
Mailing address:
  • Phone: 412-342-2288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number637032
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number637032
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number637032
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number637032
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number637032
License Number StatePA

VIII. Authorized Official

Name: MS. EMILY PIETRZAK
Title or Position: CONTROLLER
Credential: CPA
Phone: 412-342-2288