Healthcare Provider Details

I. General information

NPI: 1992002646
Provider Name (Legal Business Name): SARAH BETH BARTKO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2011
Last Update Date: 02/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 COMMERCE DR SUITE 907
MOON TWP PA
15108-4746
US

IV. Provider business mailing address

900 COMMERCE DR SUITE 907
MOON TWP PA
15108-4746
US

V. Phone/Fax

Practice location:
  • Phone: 724-991-0356
  • Fax:
Mailing address:
  • Phone: 724-991-0356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005794
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: