NPIMap

Organization Active NPI

Irene Stacy CMHC

  • Community/Behavioral Health Agency
  • Butler, PA
National Provider Identifier
1255516985
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LETTER OF APPROVAL 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

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LETTER OF APPROVAL PA Primary

Addresses

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

IdentifierTypeStateIssuer
100003515 0118MedicaidPA

Other names 1

  • Blended Case Management Other name

National Provider Directory

National Provider Directory
Tax ID family
Irene Stacy CMH Center10 organizations share this tax ID, including this one
Part of
Irene Stacy CMH Center

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1255516985",
    "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": "LETTER OF APPROVAL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003515 0118",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blended 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.