Provider Demographics
NPI:1467006569
Name:KABUSK, ALEXANDER G (LSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:G
Last Name:KABUSK
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 OHIO RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-1594
Mailing Address - Country:US
Mailing Address - Phone:412-766-9020
Mailing Address - Fax:
Practice Address - Street 1:508 3RD ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-2015
Practice Address - Country:US
Practice Address - Phone:717-599-8034
Practice Address - Fax:717-774-2172
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PASW136497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)