Healthcare Provider Details

I. General information

NPI: 1609786797
Provider Name (Legal Business Name): CHASE BURD BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 W MAIN ST FL 2
UNIONTOWN PA
15401-3303
US

IV. Provider business mailing address

1380 UNIVERSITY DR
DUNBAR PA
15431-2330
US

V. Phone/Fax

Practice location:
  • Phone: 724-438-3576
  • Fax:
Mailing address:
  • Phone: 724-438-3576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: