Healthcare Provider Details

I. General information

NPI: 1568984532
Provider Name (Legal Business Name): SARAH GRACE ROBERTSON DNP, CRN,P PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH G LONG DNP, CRN,P PMHNP-BC

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 BRODHEAD RD STE 2
MOON TOWNSHIP PA
15108-2322
US

IV. Provider business mailing address

582 FLAUGHERTY RUN RD
MOON TOWNSHIP PA
15108-8900
US

V. Phone/Fax

Practice location:
  • Phone: 412-339-1782
  • Fax: 412-754-3088
Mailing address:
  • Phone: 412-604-0329
  • Fax: 412-264-4182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberSP017643
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberSP017643
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberSP017643
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier1033743660001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: