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General NPI Number Information
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NPI Number | 1003700584
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Entity Type | Organization
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Legal Business Name | INNER PRISM COUNSELING LLC
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Dates
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Enumeration Date | 06/07/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 907 WEST ST
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City | PITTSBURGH
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State | PA
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Zip | 15221-2838
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Country | US
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Telephone | 412-528-6778
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Fax | 412-240-4658
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Provider Business Mailing Address
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Address Line | 206 PHILLIPS DR
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City | PITTSBURGH
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State | PA
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Zip | 15241-1320
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Country | US
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Telephone | 412-528-6778
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER/THERAPIST
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Name | GWENDOLYN KELLY
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Credential | LSW
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Telephone | 412-528-6778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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