Manifest Psychotherapy and Wellness

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MANIFEST PSYCHOTHERAPY AND WELLNESS

Practice address

1112 S Braddock Ave Ste 203
Pittsburgh, PA 15218-1262

Phone

(412) 407-7642

NPI assigned

Nov 19, 2018

Organization subpart

No

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

Authorized official

Name

Tara Beth Wiederstein, LPC

Title

Owner/Psychotherapist

Phone

(412) 407-7642

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Tara Beth Pannell, LPC, NBCC

  • Professional Counselor
  • Pittsburgh, PA
  • NPI 1912476045
  NPD

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1851860985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7448 SCHOYER AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152182316",
            "telephone_number": "412-425-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S BRADDOCK AVE STE 203",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152181262",
            "telephone_number": "412-407-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIFEST PSYCHOTHERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "WIEDERSTEIN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "412-407-7642",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baillie Mangus
• Simran Mangwani Mordani, MD, MSC
• Amrita Mani, MD
• Nikolaos Maniatis, MD
• Manifest Psychiatry PLLC
• Daiona Manigault, LSW
• Scott Maniglia, PA-C
• Joseph Manilla
• William Kerns Manion, D.C.
• Niveditha Manivannan, MD

• Professional Counselor in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.