Provider Demographics
NPI:1174916134
Name:COLIN O'GRADY, LLC
Entity type:Organization
Organization Name:COLIN O'GRADY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:O'GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:412-818-1276
Mailing Address - Street 1:414 ALLEGHENY RIVER BLVD.
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-9999
Mailing Address - Country:US
Mailing Address - Phone:412-818-1276
Mailing Address - Fax:
Practice Address - Street 1:414 ALLEGHENY RIVER BLVD.
Practice Address - Street 2:SUITE 204
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-9999
Practice Address - Country:US
Practice Address - Phone:412-818-1276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty