NPIMap

Organization Active NPI

Irene Stacy CMHC

  • Community/Behavioral Health Agency
  • Butler, PA
National Provider Identifier
1144405960
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
101013 Issued in PA
Legal business name
IRENE STACY CMHC
Practice address
112 Hillvue Drive
Butler, PA 16001-3498
Phone
(724) 287-0791
Fax
(724) 287-2730
NPI assigned
Dec 31, 2007
Organization subpart
Yes
Parent organization
IRENE STACY CMHCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Roger Kelly, LPC
Title
Executive Director
Phone
(724) 287-0791

Corporate family (same tax ID) 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Irene Stacy CMH Center (10 organizations share this tax ID)
Part of
Irene Stacy CMH Center

Locations

112 Hillvue Dr
Butler, PA 16001
Phone (724) 287-0791

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 101013 PA Primary

Addresses

NPPES NPI Registry

Primary practice location

112 Hillvue Drive
Butler, PA 16001-3498

Mailing address

112 Hillvue Drive
Butler, PA 16001-3498
Phone (724) 287-0791

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
100003515 0114MedicaidPA

Other names 1

NPPES NPI Registry
  • D&A Targeted Case Management Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 31, 2007.

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1144405960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HILLVUE DRIVE",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160013498",
            "telephone_number": "724-287-0791",
            "fax_number": "724-287-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HILLVUE DRIVE",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160013498",
            "telephone_number": "724-287-0791",
            "fax_number": "724-287-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRENE STACY CMHC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IRENE STACY CMHC",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "724-287-0791",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "101013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003515 0114",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D&A Targeted Case Management",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Butler, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.