Provider Demographics
NPI:1508696964
Name:PREMIER PSYCHOTHERAPY
Entity type:Organization
Organization Name:PREMIER PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-641-1567
Mailing Address - Street 1:1036 PREMIER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2155
Mailing Address - Country:US
Mailing Address - Phone:304-641-1567
Mailing Address - Fax:
Practice Address - Street 1:5150 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1626
Practice Address - Country:US
Practice Address - Phone:412-256-8869
Practice Address - Fax:141-277-4290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty