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General NPI Number Information
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NPI Number | 1780257873
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Entity Type | Organization
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Legal Business Name | CEDAR AVENUE PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 818 CEDAR AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-4812
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Country | US
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Telephone | 412-423-5352
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Fax |
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Provider Business Mailing Address
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Address Line | 818 CEDAR AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-4812
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Country | US
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Telephone | 412-423-5352
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICK WILLIAMS
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Credential | PHD
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Telephone | 412-423-5352
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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 |
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License Number State |
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