=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356111512
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WALKING FREED COUNSELING SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2024
-----------------------------------------------------
Last Update Date | 01/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 216 CEDAR BLVD
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-204-7147
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4607 LIBRARY ROAD SUITE 220 #636
-----------------------------------------------------
City | BETHEL PARK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-204-7147
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-CEO, MEMBER, COUNSELOR
-----------------------------------------------------
Name | MEGAN FREED
-----------------------------------------------------
Credential | MS, LPC, NCC
-----------------------------------------------------
Telephone | 412-204-7147
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------