NPIMap

Organization Active NPI

Irene Stacy CMHC

  • Community/Behavioral Health Agency
  • Butler, PA
National Provider Identifier
1992989750
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
101013 Issued in 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 28, 2007
Last updated
Dec 28, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
IRENE STACY CHMCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Roger A Kelly, LPC
Title
Executive Director
Phone
(724) 287-0791

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 101013 PA Primary

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 1

IdentifierTypeStateIssuer
100003515 0079MedicaidPA

Other names 1

  • Drug & Alcohol Outpatient Department Other name

National Provider Directory

National Provider Directory
Tax ID family
Irene Stacy Community M10 organizations share this tax ID, including this one
Part of
Irene Stacy Community M

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1992989750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HILLVUE DRIVE",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160013498",
            "telephone_number": "724-287-0791",
            "fax_number": "724-287-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HILLVUE DRIVE",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160013498",
            "telephone_number": "724-287-0791",
            "fax_number": "724-287-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRENE STACY CMHC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IRENE STACY CHMC",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "724-287-0791",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "101013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003515 0079",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drug & Alcohol Outpatient Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Butler, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.