Healthcare Provider Details

I. General information

NPI: 1841432184
Provider Name (Legal Business Name): WESTERN PA BEHAVIORAL HEALTH RESOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6381 NATIONAL PIKE
GRINDSTONE PA
15442-1190
US

IV. Provider business mailing address

111 ROBERTS RD STE 150
GRINDSTONE PA
15442-2104
US

V. Phone/Fax

Practice location:
  • Phone: 724-785-4346
  • Fax: 724-364-7117
Mailing address:
  • Phone: 724-785-4346
  • Fax: 724-364-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD423515
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD423515
License Number StatePA

VIII. Authorized Official

Name: BOBBI JO SHETTERLY
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 724-785-4346