Healthcare Provider Details

I. General information

NPI: 1629596242
Provider Name (Legal Business Name): MORGAN YACKEY STELMACK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2017
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 MAPLE ST.
SCRANTON PA
18505
US

IV. Provider business mailing address

921 DRINKER TPKE STE 12B
COVINGTON TOWNSHIP PA
18444-7941
US

V. Phone/Fax

Practice location:
  • Phone: 570-342-8305
  • Fax:
Mailing address:
  • Phone: 828-260-3129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW134416
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW020714
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: