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General NPI Number Information
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NPI Number | 1366526725
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Entity Type | Organization
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Legal Business Name | ALLIANCE PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 4655 WILLIAM FLYNN HWY SUITE 125B
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City | ALLISON PARK
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State | PA
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Zip | 15101-2243
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Country | US
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Telephone | 412-492-8585
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Fax | 412-492-7882
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Provider Business Mailing Address
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Address Line | 4655 WILLIAM FLYNN HWY STE 124F
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City | ALLISON PARK
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State | PA
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Zip | 15101-2248
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Country | US
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Telephone | 412-492-8585
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Fax | 412-492-7882
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA LYNN POTTGEN
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Credential | M.S.ED, LPC
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Telephone | 412-431-5665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS007065L
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License Number State | PA
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Taxonomy #2
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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 #3
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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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