Active NPI
Stairways Behavioral Health
- Clinic/Center
- Meadville, PA
National Provider Identifier
1891815429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 405900
- Legal business name
- STAIRWAYS BEHAVIORAL HEALTH
- Practice address
- 16332 Conneaut Lake Rd
Meadville, PA 16335-3843 - Phone
- (814) 337-8762
- Fax
- (814) 337-4462
- NPI assigned
- Mar 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Thomas Kirkwood
- Title
- Chief Financial Officer
- Phone
- (814) 453-5806
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 405900 | PA | |
| Professional Counselor | 101YP2500X | 405900 | PA | |
| Social Worker | 104100000X | 405900 | PA | |
| Clinical Social Worker | 1041C0700X | 405900 | PA | |
| Psychiatry Physician | 2084P0800X | 40590 | PA | |
| Clinic/Center | 261Q00000X | 405900 | PA | Primary |
Addresses
Primary practice location
16332 Conneaut Lake Rd
Meadville, PA 16335-3843
Mailing address
138 E 26TH St
Erie, PA 16504-1049
Phone (814) 453-5806
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000063480024 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040301000720 | PA | Part B Supplier - Clinic/Group Practice | 0143117697 |
Receives reassigned benefits from 20 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Erie, PA |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211500800000",
"number": "1891815429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 E 26TH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165041049",
"telephone_number": "814-453-5806",
"fax_number": "814-453-4757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16332 CONNEAUT LAKE RD",
"city": "MEADVILLE",
"state": "PA",
"postal_code": "163353843",
"telephone_number": "814-337-8762",
"fax_number": "814-337-4462"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STAIRWAYS BEHAVIORAL HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-29",
"last_updated": "2008-05-23",
"status": "A",
"authorized_official_last_name": "KIRKWOOD",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "814-453-5806",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "405900",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "PA",
"license": "405900",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "PA",
"license": "405900",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "405900",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "40590",
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "PA",
"license": "405900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000063480024",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Meadville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.