Provider Demographics
NPI:1366695462
Name:SHRAWDER, BRIAN K (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:K
Last Name:SHRAWDER
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SHERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-1114
Mailing Address - Country:US
Mailing Address - Phone:570-433-2847
Mailing Address - Fax:
Practice Address - Street 1:7095 ROUTE 287
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-6711
Practice Address - Country:US
Practice Address - Phone:570-724-5272
Practice Address - Fax:570-724-4512
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAMF00108101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health