Healthcare Provider Details

I. General information

NPI: 1003854241
Provider Name (Legal Business Name): STAIRWAYS BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 STATE ST
ERIE PA
16508-1832
US

IV. Provider business mailing address

2185 W 8TH ST
ERIE PA
16505-4747
US

V. Phone/Fax

Practice location:
  • Phone: 814-454-5686
  • Fax: 814-454-8946
Mailing address:
  • Phone: 814-464-8311
  • Fax: 814-464-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number405900
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number405900
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number405900
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number405900
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number405900
License Number StatePA
# 9
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number405900
License Number StatePA
# 10
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number405900
License Number StatePA
# 11
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number405900
License Number StatePA

VIII. Authorized Official

Name: ANN MARE ERNST
Title or Position: SUPERVISOR OF BILLING
Credential:
Phone: 814-464-8311