1568548691 NPI number — BRANDIE ELLEN WOODWARD STEWART MA, ATR-BC, LPC

Table of content: BRANDIE ELLEN WOODWARD STEWART MA, ATR-BC, LPC (NPI 1568548691)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568548691 NPI number — BRANDIE ELLEN WOODWARD STEWART MA, ATR-BC, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOODWARD STEWART
Provider First Name:
BRANDIE
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, ATR-BC, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WOODWARD
Provider Other First Name:
BRANDIE
Provider Other Middle Name:
ELLEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1568548691
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
236 E LOYALHANNA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIGONIER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15658-1316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-610-1471
Provider Business Mailing Address Fax Number:
724-995-8367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
82 HUFF AVENUE EXT STE AB
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-5483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-4227
Provider Business Practice Location Address Fax Number:
724-995-8637
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  02162 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: PC003350 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: PC0033550 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 494123 . This is a "VALUE OPTIONS PROVIDER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 202179940 . This is a "TAX IDENTIFICATION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001491706 . This is a "INDIVIDUAL HIGMARK NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 494123 . This is a "VALUE BEHAVIORAL PROVIDER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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