Organization
IRENE STACY COMMUNITY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH HAUSER (EXECUTIVE DIRECTOR)
(724) 287-0791
Entity
Organization
Contact information
Practice address
112 HILLVUE DR, BUTLER, PA 16001-3426
(724) 287-0791
(724) 287-8354
Mailing address
112 HILLVUE DR, BUTLER, PA 16001-3426
(724) 287-0791
(724) 287-8354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101013
PA
101YM0800X
Mental Health Counselor
Primary
423000
PA
101YP2500X
Professional Counselor
423000
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003515
—
PA
01
—
1007698
CBHNP-GATEWAY
PA
01
—
151407
MEDICARE PTAN
PA
01
—
201030
UPMC
PA
01
—
660502
HIGHMARK
PA
Enumeration date
07/12/2005
Last updated
05/12/2015
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