MEDICARE: LIVED EXPERIENCE PEER SUPPORT SERVICES, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	251S00000X	Community/Behavioral Health Agency
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1093676082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVED EXPERIENCE PEER SUPPORT SERVICES, INC

Provider Business Mailing Address
First Line	:	538 SPRINGWOOD DR
Second Line	:
City	:	VERONA
State	:	PA
Zip	:	15147-2626
Country	:	US
Telephone Number	:	412-525-0339
Fax Number	:	412-525-0339

Provider Business Practice Location Address
First Line	:	538 SPRINGWOOD DR
Second Line	:
City	:	VERONA
State	:	PA
Zip	:	15147-2626
Country	:	US
Telephone Number	:	412-525-0339
Fax Number	:	412-525-0339

Authorized Official
Title or Position	:	FOUNDER & EXECUTIVE DIRECTOR
Name	:	MR. ALLAN EDWARD TERRY
Credential	:	CRS
Telephone Number	:	412-525-0339

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	04/14/2026

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