Stephanie Baumgratz, PHD LMFT

Key facts

NPI

1679748313

Entity type

Individual (NPI type 1)

Primary specialty

Marriage & Family Therapist 106H00000X

License

MF000332 (PA)

Practice address

2222 Filmore Ave Ste 607
Erie, PA 16506-2984

Phone

(814) 882-4823

Fax

(814) 725-0707

NPI assigned

Apr 24, 2008

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Philosophy

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 23, 2019.

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1679748313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 PEACH ST STE 101B",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091358",
            "telephone_number": "814-882-4823",
            "fax_number": "814-725-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 FILMORE AVE STE 607",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062984",
            "telephone_number": "814-882-4823",
            "fax_number": "814-725-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGRATZ",
        "first_name": "STEPHANIE",
        "credential": "PHD LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VBH",
            "identifier": "618857",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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