Gina Marie Mattivi Stango, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017967 Issued in PA

Practice address

24 Veterans SQ
Media, PA 19063-3155

Phone

(610) 744-2526

Fax

(610) 514-9849

NPI assigned

Oct 24, 2014

Last updated

Sep 19, 2018By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, PA

  Medicare reassignment NPD
• Stango Therapeutic Solutions LLC

  • Clinical Social Worker
  • Media, PA
  • NPI 1881174951
  NPD Authorized official

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1205231842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 VETERANS SQ",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633155",
            "telephone_number": "610-744-2526",
            "fax_number": "610-514-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 VETERANS SQ",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633155",
            "telephone_number": "610-744-2526",
            "fax_number": "610-514-9849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1233 Locust St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075453",
            "country_code": "US",
            "telephone_number": "215-525-8699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANGO",
        "first_name": "GINA",
        "middle_name": "MARIE MATTIVI",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paakhi Srivastava, PH.D
• Stacey Baratz Shapiro, LCSW, LLC
• Amanda Stahl Piraino, DO
• Renee Kathleen Staiber, OTR/L, ATP
• Stango Therapeutic Solutions LLC
• Jason Stansberry, LPC, NCC
• Star Community Support Services
• Ayana Starks
• Kenneth John Stebner
• Whitney D Stedman, PT, DPT

• Clinical Social Worker in Media, PA
• Providers in Media, 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 Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.