DR. EDWARD STABA (NPI# 1275164543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275164543 |
| Entity Type | Individual |
| Full Name | DR. EDWARD STABA |
| Credential | PSY.D |
| Practice Address |
2401 W Main St Marion IL 62959-1188 |
| Mailing Address |
205 Archelle Dr Carbondale IL 62901-1956 |
| Practice Telephone | 6189975311 |
| Mailing Telephone | 5616028129 |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 071.010207 | IL | Behavioral Health & Social Service Providers |
| Street Address |
2401 W MAIN ST |
| City | MARION |
| State | IL |
| Zip Code | 62959-1188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841277696 | Keith D Stewart | Dentist | 2401 W Main St, Marion, IL 62959-1188 | 2005-12-22 |
| 1396353397 | John Gilmore | Nurse Practitioner | 2401 W Main St, Marion, IL 62959-1188 | 2020-07-16 |
| 1083230098 | Samantha Ann Kimble | Social Worker | 2401 W Main St, Marion, IL 62959-1188 | 2020-06-25 |
| 1659907954 | Jason Patton | Technician | 2401 W Main St, Marion, IL 62959-1188 | 2020-03-18 |
| 1497385918 | Megan Berkel | Technician | 2401 W Main St, Marion, IL 62959-1188 | 2020-01-23 |
| 1699316521 | Angela Trowbridge | Technician | 2401 W Main St, Marion, IL 62959-1188 | 2019-10-02 |
| 1891346276 | Donna Householder | Technician | 2401 W Main St, Marion, IL 62959-1188 | 2019-09-26 |
| 1457902918 | Brenda Frazier | Technician | 2401 W Main St, Marion, IL 62959-1188 | 2019-09-26 |
| 1043861420 | Michelle Collier | Technician | 2401 W Main St, Marion, IL 62959-1188 | 2019-09-26 |
| 1891345179 | Savanah Jayde Hardsaw | Technician | 2401 W Main St, Marion, IL 62959-1188 | 2019-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023162070 | Jeanette Hoeksema | Psychologist | 1391 N Baldwin Ave Ste 200, Marion, IN 46952-1913 | 2007-01-23 |
| 1922558618 | Holly Middleton | Psychologist | 333 E Center St, Marion, OH 43302-4101 | 2016-10-06 |
| 1033523956 | Barbara Ann Scott-johnson | Psychologist | 940 Marion Williamsport Rd E, Marion, OH 43302-8684 | 2014-06-18 |
| 1922302488 | Shabia K Alimohamed-janmohamed | Psychologist | 2401 W Main St, Marion, IL 62959-1188 | 2010-12-27 |
| 1295933315 | Robert J Marsh | Psychologist | 3905 W Ernestine Dr, Marion, IL 62959-5800 | 2007-07-10 |
| 1518096031 | Roy Shapiro | Psychologist | 320 Executive Dr, Marion, OH 43302-6310 | 2007-03-02 |
| 1881745453 | Douglas A. Daugherty | Psychologist | 5230 S Western Ave, Marion, IN 46953-5778 | 2007-01-12 |
| 1710078555 | Melody E Marley | Psychologist | 101 S Washington St, Marion, IN 46952-3867 | 2006-09-27 |
| 1982706925 | Gerald K Vasily | Psychologist | 1700 E 38th St, Marion, IN 46953-4568 | 2006-09-01 |
| 1861505059 | Arthur Kupersmith | Psychologist | 101 S Washington St, Marion, IN 46952-3867 | 2006-08-15 |
| Find all providers in MARION | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.