Carla Reed Staub, LICENSED CERTIFIED C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW000166L Issued in PA

Practice address

129 Charles St
Hanover, PA 17331-1807

Phone

(717) 524-9326

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Mrs. Carla Reed Staub Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Truenorth Wellness Services

  • Community/Behavioral Health Agency
  • Hanover, PA
  • NPI 1912013509
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1083799563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 FRANKLIN CT",
            "city": "MCSHERRYSTOWN",
            "state": "PA",
            "postal_code": "173441130",
            "telephone_number": "717-637-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 CHARLES ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311807",
            "telephone_number": "717-524-9326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUB",
        "first_name": "CARLA",
        "middle_name": "REED",
        "name_prefix": "Mrs.",
        "credential": "LICENSED CERTIFIED C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW000166L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CENTRAL PREFERRED",
            "identifier": "1083799563",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLSPAN",
            "identifier": "1083799563",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1083799563",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1083799563",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02831600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "1083799563",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "STAUB",
            "middle_name": "REED",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew Steven Stake, PA-C
• Ann Louise Stambach, O.D.
• Jeannette A Stambaugh, CRNP
• Amanda Staub
• Amanda Staub
• Perpetua Ann Staub, MD
• Faye Stec
• Rebecca Stevens, PT
• Sarah Stich
• Christine Stoner

• Clinical Social Worker in Hanover, PA
• Providers in Hanover, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.