Edward Staba, PSY.D

Psychologist · Marion, IL

Individual Active NPI

NPI number 1275164543

Practice location

2401 W Main St
Marion, IL 62959-1188
Phone
(618) 997-5311

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NPI record

NPI
1275164543
Entity type
Individual (Type 1)
Enumeration date
January 27, 2020
Last updated
January 27, 2020
Certified
January 27, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X 071.010207 IL

Mailing address

205 Archelle Dr
Carbondale, IL 62901-1956
Phone
(561) 602-8129

About Dr. Staba

Edward Staba, PSY.D is a healthcare provider registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 2401 W Main St, Marion, IL 62959-1188. The NPI number 1275164543 was assigned on January 27, 2020 and the record was last updated on January 27, 2020.

Dr. Staba lists a license in the registry: #071.010207 (IL) for Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Edward Staba, PSY.D?

The NPI number is 1275164543.

What is the phone number of Dr. Staba?

The phone number listed for the practice location is (618) 997-5311.

Where is Dr. Staba located?

2401 W Main St, Marion, IL 62959-1188.

What is the taxonomy code for Dr. Staba?

The primary taxonomy code is 103T00000X – Psychologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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