MEDICARE: NORTHBRIDGE PSYCHIATRIC CARE, PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1811844277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHBRIDGE PSYCHIATRIC CARE, PLLC

Provider Business Mailing Address
First Line	:	4801 MCKNIGHT RD # 1188
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-3423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 MCKNIGHT RD # 1188
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-3423
Country	:	US
Telephone Number	:	878-723-5412
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JERRY DAVIS
Credential	:	PMHNP-BC
Telephone Number	:	878-723-5412

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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