Irene Stacy CMHC
Organization Active NPI Community/Behavioral Health Agency · Butler, PA
NPI 1740465475 · NPPES record last updated Dec 31, 2007
Key facts
- NPI
- 1740465475
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 457480 (PA)
- Legal business name
- IRENE STACY CMHC
- Practice address
- 112 Hillvue Drive
Butler, PA 16001-3498 - Phone
- (724) 287-0791
- Fax
- (724) 287-2730
- NPI assigned
- Dec 31, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- IRENE STACY CMHC
Authorized official
- Name
- Roger A Kelly, LPC
- Title
- Executive Director
- Phone
- (724) 287-0791
Corporate family (same tax ID) 9
Practitioners 2
-
Peter Moskel, M.D.
National Provider Directory
- Tax ID family
- Irene Stacy CMH Center
- Part of
- Irene Stacy CMH Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 457480 | PA | Yes |
Addresses
Primary practice location
112 Hillvue Drive
Butler, PA 16001-3498
Mailing address
112 Hillvue Drive
Butler, PA 16001-3498
Phone (724) 287-0791
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100003515 0069 | Medicaid | PA |
Other names
- Family Based Program
Other providers in Butler, PA
- Irene Stacy CMHC
- Irene Stacy CMHC
- Irene Stacy CMHC
- Irene Stacy CMHC
- Irene Stacy CMHC
- Irene Stacy CMHC
- Irene Stacy CMHC
- Irene Stacy Community Mental Health Center
- Erin Leigh Irvin
- Janet Isherwood
All providers in Butler, PA · Community/Behavioral Health Agency in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.