KELLY STICKLER CDCA.183687 NPI 1477201309

NPI Information

NPI: 1477201309
Provider Name: KELLY STICKLER, CDCA.183687
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
323 MARION PIKE STE 1
COAL GROVE, OH
ZIP 45638
Phone: (740) 237-4981
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Kelly Stickler, CDCA.183687 is an addiction (substance use disorder) counselor in Coal Grove, OH. Kelly Stickler, CDCA.183687 NPI is 1477201309. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

323 MARION PIKE STE 1
COAL GROVE, OH
ZIP 45638-958
Phone: (740) 237-4981
Fax: (877) 325-2816

The enumeration date for this NPI number is 3/10/2022 and was last updated on 10/18/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YM0800X	Counselor	Mental Health	No
2	171M00000X	Case Manager/Care Coordinator		No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0478644	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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