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NPI Code Detail

MEDICARE: RADIANT SELF COUNSELING LLC

MEDICARE: RADIANT SELF COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1063248789
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIANT SELF COUNSELING LLC
Provider Business Mailing Address
First Line : 2515 BANKSVILLE RD # 1032
Second Line :
City : PITTSBURGH
State : PA
Zip : 15216-2809
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 413 EDGEMONT ST
Second Line :
City : MT WASHINGTON
State : PA
Zip : 15211-2405
Country : US
Telephone Number : 412-576-8288
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ELIZABETH SAMMONS
Credential : MA LPC
Telephone Number : 412-324-7708
Provider Enumeration Date : 09/10/2024
Last Update Date : 09/10/2024

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Directions to “RADIANT SELF COUNSELING LLC ” Practice Location

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