Medicare

LBN: Irene Stacy Cmhc
Medicare is an health care organization with primary practice located at 112 Hillvue Drive , Butler PA 16001-3498. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Irene Stacy Cmhc can be contacted via phone (724) 287-0791, or through Kelly, Roger via phone (724) 287-0791.

Contact Information

Primary practice address
112 Hillvue Drive Butler PA 16001-3498
Phone: (724) 287-0791
Fax: (724) 287-2730
Website:
Map and Directions
Authorized official contact:
Name: Kelly, Roger Licensed Professional Counselor (LPC)
Phone: (724) 287-0791

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X 423000 Pennsylvania

Profile Details

NPI number 1063697795
LBN Legal business name Irene Stacy Cmhc
DBA Doing business as Medicare
Authorized official Kelly, Roger Licensed Professional Counselor (LPC)
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 31st, 2007
Last updated Dec 31st, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063697795 NPPES
Pennsylvania MEDICAID 1000003515 0080

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