Brenda Sue Staerker

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW022295 Issued in PA

Practice address

228 S Main Ave
Scranton, PA 18504-2545

Phone

(570) 904-7363

Fax

(570) 348-4079

NPI assigned

Apr 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Thaxton Holistic Wellness Center

  • Professional Counselor
  • Scranton, PA
  • NPI 1609243898
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1556409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1447814140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 S MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042545",
            "telephone_number": "570-904-7363",
            "fax_number": "570-348-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 S MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042545",
            "telephone_number": "570-904-7363",
            "fax_number": "570-348-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAERKER",
        "first_name": "BRENDA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-28",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW136002",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Archana Sridhar, M.B.B.S.
• Zaria Samaiyah St Lawrence, DPM
• St. Joseph's Center
• St. Joseph's Center
• Andrea B Stachnick, CRNA
• Bennett Stahl, MS
• Jamie S Stallman, MD
• Kimberly Rene Stampien, D.M.D.
• Ted Michael Stampien, M.D.
• Maureen Marguerite Staples, LCSW

• Clinical Social Worker in Scranton, PA
• Providers in Scranton, 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 Aug 3, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.