Active NPI
Sandra Stagg-Young, LMSW
- Social Worker
- Edwardsville, PA
National Provider Identifier
1649038977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 121262
- Practice address
- 512 Northhampton Street
Unit 151
Edwardsville, PA 18704-4560 - Phone
- (570) 755-5118
- NPI assigned
- Mar 11, 2024
- Last updated
- Mar 11, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 121262 | NY | Primary |
Addresses
Primary practice location
512 Northhampton Street
Unit 151
Edwardsville, PA 18704-4560
Mailing address
512 Northhampton Street
Unit 151
Edwardsville, PA 18704-4560
Phone (570) 755-5118
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 |
|---|---|---|---|
| 121262 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1649038977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 NORTHHAMPTON STREET",
"address_2": "UNIT 151",
"city": "EDWARDSVILLE",
"state": "PA",
"postal_code": "187044560",
"telephone_number": "570-755-5118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 NORTHHAMPTON STREET",
"address_2": "UNIT 151",
"city": "EDWARDSVILLE",
"state": "PA",
"postal_code": "187044560",
"telephone_number": "570-755-5118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAGG-YOUNG",
"first_name": "SANDRA",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-11",
"last_updated": "2024-03-11",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "121262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edwardsville, PA
- Alysa Pat Scavone
- Maryann Ostrowski Schramm, CRNA
- Marci Lynn Barr Schwartz, SC.M.
- Charles Joseph Scrobola, M.D.
- Shelly a Levulis
- Alexis Steeber, OTD, OTR/L, CLT
- Mohammad Khaled Tashkandi, M.D.
- The Endoscopy Center at Gateway LLC
- Turosky Chiropractic Clinic
- Turosky Chiropractic Clinic, PC (Turosky Natural Healing Centre)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.