Healthcare Provider Details

I. General information

NPI: 1023284486
Provider Name (Legal Business Name): PATRICK K ZBASNIK JR. MS, LPC, LBS, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 PAINTERSVILLE ROAD
NEW STANTON PA
15672
US

IV. Provider business mailing address

3233 NIAGARA SQ
PITTSBURGH PA
15213-4276
US

V. Phone/Fax

Practice location:
  • Phone: 347-469-1538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH003224
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008765
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: