Individual provider Active NPI

Edna Stickell, LCSW

  • Counselor
  • Erie, PA
National Provider Identifier
1639572076
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CW016547 Issued in PA
Practice address
2911 State St
Erie, PA 16508-1831
Phone
(814) 464-8311
Fax
(814) 464-8462
NPI assigned
Sep 30, 2014
Last updated
Sep 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CW016547 PA Primary

Addresses

Primary practice location

2911 State St
Erie, PA 16508-1831

Mailing address

2185 W 8TH St
Erie, PA 16505-4747
Phone (814) 464-8311

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170922001100 PA Practitioner - Clinical Social Worker 5193099620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stairways Behavioral HealthGroup PAC ID 0143117697, 16 clinicians

Practice addresses (Care Compare)

2910 State St
Erie, PA 16508-1832
Phone (814) 464-8311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW016547PAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stairways Behavioral Health CurrentSince Jul 15, 2017 Accepting new patients
Stairways Behavioral Health Past Accepting new patients

Locations

2185 W 8th St
Erie, PA 16505
Phone (814) 464-8311

2910 State St
Erie, PA 16508
Phone (814) 454-5686

2911 State St
Erie, PA 16508
Phone (814) 453-5806

Organizations & group practices 2

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": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1639572076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 W 8TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054747",
            "telephone_number": "814-464-8311",
            "fax_number": "814-464-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081831",
            "telephone_number": "814-464-8311",
            "fax_number": "814-464-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKELL",
        "first_name": "EDNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "CW016547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.