MEDICARE: ALLEGHENY ART THERAPY & PERSONAL CONSULTING, 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
1	251S00000X	Community/Behavioral Health Agency	PC005401	PA

General Provider Information

NPI Number	:	1760782304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGHENY ART THERAPY & PERSONAL CONSULTING, LLC

Provider Business Mailing Address
First Line	:	106 RIVERSIDE DR
Second Line	:	PO BOX 233
City	:	MCGRANN
State	:	PA
Zip	:	16236
Country	:	US
Telephone Number	:	724-840-6023
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 RIVERSIDE DR
Second Line	:
City	:	MCGRANN
State	:	PA
Zip	:	16236
Country	:	US
Telephone Number	:	724-840-6023
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MELANIE LYNNE BEUTH
Credential	:	LPC
Telephone Number	:	724-840-6023

Provider Enumeration Date	:	10/29/2010
Last Update Date	:	10/29/2010

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