Healthcare Provider Details

I. General information

NPI: 1710933569
Provider Name (Legal Business Name): CAROL ANN STENGER MSW LCSW BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

963 SOUTH 5TH AVE
CLARION PA
16214-8619
US

IV. Provider business mailing address

963 SOUTH 5TH AVE
CLARION PA
16214-8619
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-9810
  • Fax: 814-226-0205
Mailing address:
  • Phone: 814-226-9810
  • Fax: 814-226-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW007115L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier214487
Identifier TypeOTHER
Identifier State
Identifier IssuerMANAGED HEALTH NETWORK
# 2
Identifier304527
Identifier TypeOTHER
Identifier State
Identifier IssuerUPMC
# 3
IdentifierA128048
Identifier TypeOTHER
Identifier State
Identifier IssuerVALUE BEHAVIORAL HEALTH &
# 4
IdentifierST866641
Identifier TypeOTHER
Identifier State
Identifier IssuerHIGHMARK
# 5
Identifier6522432
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 6
Identifier01784925
Identifier TypeOTHER
Identifier State
Identifier IssuerMEDICAL ASSISTANCE PA
# 7
IdentifierPO14479
Identifier TypeOTHER
Identifier State
Identifier IssuerTRICARE STANDARD REGION 1
# 8
Identifier143715
Identifier TypeOTHER
Identifier State
Identifier IssuerUNITED BEHAVIORAL HEALTH
# 9
Identifier76699
Identifier TypeOTHER
Identifier State
Identifier IssuerHEALTH AMERICA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: