Individual provider Active NPI

Robert Stahl

  • Professional Counselor
  • Philadelphia, PA
National Provider Identifier
1154102325
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC011056 Issued in PA
Practice address
1518 Walnut St Ste 202&208
Philadelphia, PA 19102-3419
Phone
(855) 284-7483
NPI assigned
Oct 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC011056 PA Primary

Addresses

Primary practice location

1518 Walnut St Ste 202&208
Philadelphia, PA 19102-3419

Mailing address

PO Box 748465
Atlanta, GA 30374-8465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231211003701 PA Practitioner - Mental Health Counselor 8921457359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

205 N Broad St 1St Floor
Jefferson Internal Medicine Assocs
Philadelphia, PA 19107-1554
Phone (215) 587-8008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC011056PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jan 26, 2025 Accepting new patients

Locations

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

205 N Broad St
Fl 1
Philadelphia, PA 19107
Phone (215) 587-8008

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

3 Crescent Dr
Ste 100
Philadelphia, PA 19112
Phone (215) 503-3300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1154102325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST STE 202&208",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023419",
            "telephone_number": "855-284-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC011056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.