Provider Demographics
NPI:1285789776
Name:WESLEY SPECTRUM SERVICES
Entity type:Organization
Organization Name:WESLEY SPECTRUM SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETRZAK
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:412-342-2288
Mailing Address - Street 1:221 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:WILKINSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15221-2118
Mailing Address - Country:US
Mailing Address - Phone:412-342-2288
Mailing Address - Fax:
Practice Address - Street 1:90 W CHESTNUT ST STE 200EW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4524
Practice Address - Country:US
Practice Address - Phone:724-222-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA637032101YA0400X, 106H00000X, 251B00000X, 251S00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA131726OtherKHPW
PA1001340160022Medicaid
PA329484A013419OtherVBH OF PA
PA1001340160021Medicaid
PA1001340160026Medicaid
PA1001340160028Medicaid