Individual provider Active NPI

Stephanie Loebs, RN

  • Addiction (Substance Use Disorder) Counselor
  • Bala Cynwyd, PA
National Provider Identifier
1629511514
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RN665405 Issued in PA
Practice address
225 E City Ave
Suite 15
Bala Cynwyd, PA 19004-1704
Phone
(484) 430-4200
NPI assigned
Nov 23, 2016
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RN665405 PA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 26NR15196500 NJ
Addiction (Substance Use Disorder) Counselor 101YA0400X 0001093481 VA

Addresses

Primary practice location

225 E City Ave
Suite 15
Bala Cynwyd, PA 19004-1704

Mailing address

255 E. City Avenue
Suite 15
Bala Cynwyd, PA 19004
Phone (484) 430-4200

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR15196500NJMDAddiction (Substance Use Disorder) Counselor
RN665405PAMDAddiction (Substance Use Disorder) Counselor
0001093481VAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life of Purpose - Pennsylvania Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1629511514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E. CITY AVENUE",
            "address_2": "SUITE 15",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "19004",
            "telephone_number": "484-430-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CITY AVE",
            "address_2": "SUITE 15",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041704",
            "telephone_number": "484-430-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEBS",
        "first_name": "STEPHANIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "RN665405",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "26NR15196500",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0001093481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.