Provider Demographics
NPI:1063398170
Name:IRONS, SAMUEL R
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:R
Last Name:IRONS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WOODLAND RD # SMB696
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2871
Mailing Address - Country:US
Mailing Address - Phone:804-895-3639
Mailing Address - Fax:
Practice Address - Street 1:5880 ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1793
Practice Address - Country:US
Practice Address - Phone:412-444-8340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health