Provider Demographics
NPI:1568984532
Name:ROBERTSON, SARAH GRACE (DNP, CRN,P PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:DNP, CRN,P PMHNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:G
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, CRN,P PMHNP-BC
Mailing Address - Street 1:582 FLAUGHERTY RUN RD
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-8900
Mailing Address - Country:US
Mailing Address - Phone:412-604-0329
Mailing Address - Fax:412-264-4182
Practice Address - Street 1:1010 BRODHEAD RD STE 2
Practice Address - Street 2:
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-2322
Practice Address - Country:US
Practice Address - Phone:412-339-1782
Practice Address - Fax:412-754-3088
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP0176432084P0804X, 2084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033743660001Medicaid