Provenance Counseling and Wellness, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PROVENANCE COUNSELING AND WELLNESS, LLC

Practice address

5001 Baum Blvd Ste 484
Pittsburgh, PA 15213-1852

Phone

(412) 223-7290

NPI assigned

Dec 2, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Quiana M Golphin, PHD, LPC, NCCNPI 1720735327

Title

Licensed Professional Counselor

Phone

(412) 223-7290

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.

• Quiana Golphin, PH.D.

  • Professional Counselor
  • Pittsburgh, PA
  • NPI 1720735327
  NPD Authorized official

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1881304533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 BAUM BLVD STE 484",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131852",
            "telephone_number": "412-223-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 BAUM BLVD STE 484",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131852",
            "telephone_number": "412-223-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVENANCE COUNSELING AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "GOLPHIN",
        "authorized_official_first_name": "QUIANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "412-223-7290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.