Kelly E. Maffia, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW014449 Issued in PA

Practice address

4133 Medical Center Dr
Broad Top, PA 16621-9001

Phone

(814) 635-2916

Fax

(814) 635-2918

NPI assigned

Jul 17, 2006

Last updated

Jun 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Kelly E States Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: k.maffia@broadtopmedical.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Broad Top Area Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Broad Top, PA
  • NPI 1063514453
  Medicare reassignment NPD
• Broad Top Area Medical Center Inc

  dba Juniata Valley BTAMC Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, PA
  • NPI 1437878667
  NPD
• Broad Top Area Medical Center Inc

  dba BTAMC Walk In Clinic

  • Federally Qualified Health Center (FQHC)
  • Huntingdon, PA
  • NPI 1649769589
  NPD (past)
• Mainstream Counseling

  • Community/Behavioral Health Agency
  • Huntingdon, PA
  • NPI 1720131311
  NPD (past)
• Mainstreamcounseling

  • Addiction (Substance Use Disorder) Counselor
  • Huntingdon, PA
  • NPI 1114372026

  Clinical

  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1518985605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 CRESTWOOD DR",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166528257",
            "telephone_number": "814-599-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 MEDICAL CENTER DR",
            "city": "BROAD TOP",
            "state": "PA",
            "postal_code": "166219001",
            "telephone_number": "814-635-2916",
            "fax_number": "814-635-2918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Washington St",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "PA",
            "postal_code": "166521725",
            "country_code": "US",
            "telephone_number": "814-506-8114",
            "fax_number": "814-506-8553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6674 Towne Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "PA",
            "postal_code": "166526934",
            "country_code": "US",
            "telephone_number": "814-643-1232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "95 S Park St",
            "address_purpose": "LOCATION",
            "city": "Mount Union",
            "state": "PA",
            "postal_code": "170661334",
            "country_code": "US",
            "telephone_number": "814-542-8627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "790 Bryan St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "PA",
            "postal_code": "166522410",
            "country_code": "US",
            "telephone_number": "814-643-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6678 Towne Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "PA",
            "postal_code": "166526934",
            "country_code": "US",
            "telephone_number": "814-506-8490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "478 Seminary St.",
            "address_purpose": "LOCATION",
            "city": "Cassville",
            "state": "PA",
            "postal_code": "166230158",
            "country_code": "US",
            "telephone_number": "814-448-9226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Washington St",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "PA",
            "postal_code": "166521826",
            "country_code": "US",
            "telephone_number": "814-643-1114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAFFIA",
        "first_name": "KELLY",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022409020001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102240902-0002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "1667176",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "STATES",
            "middle_name": "E",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Jean Brode, DPT
• Josepha Louise Brown, RNP
• Brian G. Cole, M.D., M.PH.
• Fawzia Haque, MD
• Kevin Michael Hepler, MD
• John D Roth, M.D.
• Michelle Volpe, CRNP-BC

• Clinical Social Worker in Broad Top, PA
• Providers in Broad Top, 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 Jun 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.