Stacia Ann Shirley

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.177613 Issued in OH

Practice address

680 Northland Blvd
Cincinnati, OH 45240-3248

Phone

(513) 941-4999

Fax

(513) 694-0168

NPI assigned

Jun 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1972129583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 HARRISON AVE STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477958",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 NORTHLAND BLVD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452403248",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "STACIA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.173892",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.177613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0407485",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leighann Shirk, MSW, LISW-S
• Samantha Shirk, D.O.
• Michele Shirley
• Minta J. Shirley, NURSE PRACTITIONER
• Sierra Shirley
• Tracy L Shirley
• Shirley'S Comfort Care LLC
• Kaylee Shiveley
• Savannah Shiveley
• Amy Marie Shively

• Addiction (Substance Use Disorder) Counselor in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.