1245268358 NPI number — MISS MARY JANE BEATTY LMFT

Table of content: MISS MARY JANE BEATTY LMFT (NPI 1245268358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245268358 NPI number — MISS MARY JANE BEATTY LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEATTY
Provider First Name:
MARY JANE
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245268358
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9000 BABCOCK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLISON PARK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15101-2713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-366-1300
Provider Business Mailing Address Fax Number:
412-366-1333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 MCKNIGHT PARK DR
Provider Second Line Business Practice Location Address:
SUITE 802
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15237-6504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-366-1300
Provider Business Practice Location Address Fax Number:
412-366-1333
Provider Enumeration Date:
06/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  MF000096 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: MF000096 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: MF000096 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)