Individual provider Active NPI

Courtney Elizabeth Stasko

  • Social Worker
  • Ebensburg, PA
National Provider Identifier
1417516816
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW134275 Issued in PA
Practice address
358 Industrial Park Rd
Ebensburg, PA 15931-4116
Phone
(814) 472-6105
Fax
(814) 472-0865
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW134275 PA Primary

Addresses

Primary practice location

358 Industrial Park Rd
Ebensburg, PA 15931-4116

Mailing address

202 Klondike Rd
Patton, PA 16668-6901
Phone (814) 414-6510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW134275PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1417516816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 KLONDIKE RD",
            "city": "PATTON",
            "state": "PA",
            "postal_code": "166686901",
            "telephone_number": "814-414-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 INDUSTRIAL PARK RD",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314116",
            "telephone_number": "814-472-6105",
            "fax_number": "814-472-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASKO",
        "first_name": "COURTNEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW134275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.