Provider Demographics
NPI:1417786161
Name:NICHOLAS GEORGE PELESCAK
Entity type:Organization
Organization Name:NICHOLAS GEORGE PELESCAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:PELESCAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-915-4730
Mailing Address - Street 1:510 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-2226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 WESTERN AVE STE 204
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15233-1719
Practice Address - Country:US
Practice Address - Phone:412-915-4730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)