NPIMap

Organization Active NPI

A Wellness Place LLC

  • Social Worker
  • Pittsburgh, PA
National Provider Identifier
1154746410
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CW16629 Issued in PA
Legal business name
A WELLNESS PLACE LLC
Practice address
8350 Frankstown Ave
Pittsburgh, PA 15221-1336
Phone
(412) 583-7505
Fax
(412) 342-0402
NPI assigned
Feb 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy J Gonzalez, LCSWNPI 1689813750
Title
Owner
Phone
(412) 583-7505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X CW16629 PA Primary

Addresses

Primary practice location

8350 Frankstown Ave
Pittsburgh, PA 15221-1336

Mailing address

471 Shelbourne Dr
Pittsburgh, PA 15239-3613
Phone (412) 583-7505

Other practice location 1

4110 Monroeville Blvd
Monroeville, PA 15146-2618
Phone (412) 583-7505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240912000377 PA Part B Supplier - Clinic/Group Practice 6103366588 Receives reassigned benefits from 2 practitioners
Practice locations: Monroeville, PA

National Provider Directory

National Provider Directory

Locations

4110 Monroeville Blvd
Monroeville, PA 15146
Phone (412) 583-7505

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1154746410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 SHELBOURNE DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152393613",
            "telephone_number": "412-583-7505",
            "fax_number": "412-342-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 FRANKSTOWN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152211336",
            "telephone_number": "412-583-7505",
            "fax_number": "412-342-0402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4110 Monroeville Blvd",
            "address_purpose": "LOCATION",
            "city": "Monroeville",
            "state": "PA",
            "postal_code": "151462618",
            "country_code": "US",
            "telephone_number": "412-583-7505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A WELLNESS PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-583-7505",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW16629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.