Provider Demographics
NPI:1316092596
Name:WESLEY SPECTRUM SERVICES
Entity type:Organization
Organization Name:WESLEY SPECTRUM SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SZPARA
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:412-831-9390
Mailing Address - Street 1:243 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SAINT CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2534
Mailing Address - Country:US
Mailing Address - Phone:412-831-9390
Mailing Address - Fax:412-831-8868
Practice Address - Street 1:6117 BROAD ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3011
Practice Address - Country:US
Practice Address - Phone:412-831-9390
Practice Address - Fax:412-831-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA707179101YA0400X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001340160025Medicaid
PA329484A042016OtherVBH OF PA