Individual provider Active NPI

Stephanie Michelle Dansky, LCSW

  • Clinical Social Worker
  • Rincon, GA
National Provider Identifier
1053897009
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006980 Issued in GA
Practice address
135 Goshen Road Ext Ste 256
Rincon, GA 31326-5575
Phone
(912) 421-1000
Fax
(912) 421-1189
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW006980 GA Primary

Addresses

Primary practice location

135 Goshen Road Ext Ste 256
Rincon, GA 31326-5575

Mailing address

135 Goshen Road Ext Ste 256
Rincon, GA 31326-5575
Phone (912) 421-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW006980GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Counseling, Inc CurrentSince Sep 24, 2023 Accepting new patients

Locations

135 Goshen Road Ext
Ste 203
Rincon, GA 31326
Phone (912) 355-3881

135 Goshen Road Ext
Ste 256
Rincon, GA 31326
Phone (912) 421-1000

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1053897009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GOSHEN ROAD EXT STE 256",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265575",
            "telephone_number": "912-421-1000",
            "fax_number": "912-421-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GOSHEN ROAD EXT STE 256",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265575",
            "telephone_number": "912-421-1000",
            "fax_number": "912-421-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANSKY",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.