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NPI Code Detail

MEDICARE: FOURTH RIVER THERAPY LLC

MEDICARE: FOURTH RIVER THERAPY 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1700508108
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOURTH RIVER THERAPY LLC
Provider Business Mailing Address
First Line : 2000 E CARSON ST STE 250
Second Line :
City : PITTSBURGH
State : PA
Zip : 15203-1957
Country : US
Telephone Number : 412-609-6762
Fax Number : 412-404-3972
Provider Business Practice Location Address
First Line : 2000 E CARSON ST STE 250
Second Line :
City : PITTSBURGH
State : PA
Zip : 15203-1957
Country : US
Telephone Number : 412-609-6762
Fax Number : 412-404-3972
Authorized Official
Title or Position : OWNER
Name : ASHLEY GALLO
Credential : LCSW
Telephone Number : 412-609-6762
Provider Enumeration Date : 09/13/2022
Last Update Date : 04/13/2025

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Directions to “FOURTH RIVER THERAPY LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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