Alicia Dawn Stellwagen, LPC, NCC, MAC, AADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1951 Issued in WV

Practice address

47 Shenandoah Dr
Davisville, WV 26142-1003

Phone

(304) 488-7898

NPI assigned

Apr 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Keystone Marion, LLC

  • Psychiatric Residential Treatment Facility
  • Marion, VA
  • NPI 1275732695
  NPD (past)
• Keystone Marion, LLC

  • Psychiatric Residential Treatment Facility
  • Marion, VA
  • NPI 1386663516
  NPD (past)

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1285807263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 SHENANDOAH DR",
            "city": "DAVISVILLE",
            "state": "WV",
            "postal_code": "261421003",
            "telephone_number": "304-488-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 SHENANDOAH DR",
            "city": "DAVISVILLE",
            "state": "WV",
            "postal_code": "261421003",
            "telephone_number": "304-488-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLWAGEN",
        "first_name": "ALICIA",
        "middle_name": "DAWN",
        "credential": "LPC, NCC, MAC, AADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": "301125",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WV",
            "license": "10-302",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "509209",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Martin
• Ashley McCarthy
• Leda Keonne McClure
• Ritchie County Primary Care Assoc., Inc.
• Skyhawk Traffic Inc
• Ashley Dawn True
• Holly Michelle West
• Jeri Woodward

• All providers in Davisville, WV
• Professional Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.