Healthcare Provider Details

I. General information

NPI: 1760017669
Provider Name (Legal Business Name): DONALD SHARBAUGH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 WALNUT ST
MCKEESPORT PA
15132-2801
US

IV. Provider business mailing address

4606 VINE ST
MCKEESPORT PA
15132-6417
US

V. Phone/Fax

Practice location:
  • Phone: 412-675-6927
  • Fax:
Mailing address:
  • Phone: 412-417-1675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: