Individual provider Active NPI

Stacy Erin Doney, LCSW

  • Clinical Social Worker
  • Elkton, MD
National Provider Identifier
1003097999
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14346 Issued in MD
Practice address
26 Chesters Way
Elkton, MD 21921-4506
Phone
(443) 485-8652
NPI assigned
Nov 19, 2007
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Q1-0000898 DE
Clinical Social Worker 1041C0700X 14346 MD Primary

Addresses

Primary practice location

26 Chesters Way
Elkton, MD 21921-4506

Mailing address

26 Chesters Way
Elkton, MD 21921-4506
Phone (443) 485-8652

Other identifiers 1

IdentifierTypeStateIssuer
1003097999MedicaidMD

Other names 1

  • Ms. Stacy Erin Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240308000234 MD Practitioner - Clinical Social Worker 7012097413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians

Practice addresses (Care Compare)

Baltimore, MD 21212
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0000898DEMDClinical Social Worker
14346MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Feb 1, 2024 Accepting new patients
Annette's Haven Clinical Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

5835 York Rd
Baltimore, MD 21212
Phone (443) 877-5308

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1003097999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CHESTERS WAY",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219214506",
            "telephone_number": "443-485-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CHESTERS WAY",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219214506",
            "telephone_number": "443-485-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONEY",
        "first_name": "STACY",
        "middle_name": "ERIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000898",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003097999",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "MOORE",
            "middle_name": "ERIN",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.