Elizabeth E. Staas, LSW CDCA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1000277 Issued in OH

Practice address

131 N. Main St.
Marysville, OH 43040

Phone

(937) 642-1254

Fax

(937) 642-2806

NPI assigned

Jul 18, 2008

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

Other identifiers 1

Other names 1

• Elizabeth M. Evangelista Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1629233655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817",
            "address_2": "1521 N. DETROIT ST.",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433570817",
            "telephone_number": "937-465-8065",
            "fax_number": "937-465-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N. MAIN ST.",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "43040",
            "telephone_number": "937-642-1254",
            "fax_number": "937-642-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAS",
        "first_name": "ELIZABETH",
        "middle_name": "E.",
        "credential": "LSW CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1000277",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "101076",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MC1705",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "EVANGELISTA",
            "middle_name": "M.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shelley Anne Soviak, LISW
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• Spine and Pain Care Consultants
• Tara Lynn St Louis, LSW
• Erin St. Germain, LISW
• Eryn Lynne Staats, AUD
• Elizabeth Stahler, PHARMD
• Linda Anne Staley, M.D.
• Ashley Stalling, LISW
• Anna Stalnaker

• Clinical Social Worker in Marysville, OH
• Providers in Marysville, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.