Active NPI
Mary V Eagen
- Counselor
- Ridgway, PA
National Provider Identifier
1497936181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- PC004003
- Practice address
- 110 Lincoln St
Ridgway, PA 15853-1939 - Phone
- (814) 776-2145
- NPI assigned
- Nov 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | PC004003 | PA | Primary |
Addresses
Primary practice location
110 Lincoln St
Ridgway, PA 15853-1939
Mailing address
110 Lincoln St
Ridgway, PA 15853-1939
Phone (814) 776-2145
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
| License | State | Type | Specialty |
|---|---|---|---|
| PC004003 | PA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195603200000",
"number": "1497936181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 LINCOLN ST",
"city": "RIDGWAY",
"state": "PA",
"postal_code": "158531939",
"telephone_number": "814-776-2145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 LINCOLN ST",
"city": "RIDGWAY",
"state": "PA",
"postal_code": "158531939",
"telephone_number": "814-776-2145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGEN",
"first_name": "MARY",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-21",
"last_updated": "2007-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "PC004003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgway, PA
- Dubois Regional Medical Center
- Dubois Regional Medical Center
- Dubois Regional Medical Center
- Dubois Regional Medical Center
- Dubois Regional Medical Center - Penn Highlands Gen Surgery Ridgeway
- Elk Regional Health Center, Inc.
- Elk Regional Professional Group Inc
- Elk Regional Professional Group, Inc.
- Elk Regional Professional Group, Inc.
- Elk Regional Professional Group, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.