Basic Information
| Provider Information | |||||||||
| NPI: | 1316325293 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCARISBRICK | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 930 CHESTNUT RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265052807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045984214 | ||||||||
| FaxNumber: | 3042932325 | ||||||||
| Practice Location | |||||||||
| Address1: | 930 CHESTNUT RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265052807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045984214 | ||||||||
| FaxNumber: | 3042932325 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2015 | ||||||||
| LastUpdateDate: | 04/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | PSY.0004229 | CO | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103TC0700X | PSY.0004229 | CO | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | 81318 | WV | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.