=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386297075
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADAM PRITCHARD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2019
-----------------------------------------------------
Last Update Date | 10/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 N WHITFIELD ST STE 302
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15206-3039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-212-6909
-----------------------------------------------------
Fax | 412-228-4497
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 190 MATCH FACTORY PL
-----------------------------------------------------
City | BELLEFONTE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16823-1367
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-355-3151
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | APC000387
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 175T00000X
-----------------------------------------------------
Taxonomy Name | Peer Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------