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General NPI Number Information
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NPI Number | 1831768977
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Entity Type | Organization
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Legal Business Name | ELEVATION PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 440 PELLIS RD UNIT A
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City | GREENSBURG
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State | PA
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Zip | 15601-4529
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Country | US
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Telephone | 724-216-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 440 PELLIS RD UNIT A
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City | GREENSBURG
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State | PA
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Zip | 15601-4529
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Country | US
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Telephone | 724-216-3588
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/PARTNER
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Name | DR. SUSAN MASTRUSERIO
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Credential | PSYD
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Telephone | 412-996-3306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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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 | 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 #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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