Stacey Jean Hagen, LCSWC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

08288 Issued in MD

Practice address

49 Old Solomons Island Rd
Ste 303
Annapolis, MD 21401-3854

Phone

(410) 573-1944

Fax

(410) 573-1972

NPI assigned

Nov 9, 2005

Last updated

Jul 18, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: waypointwellnesscenter.staceyhagen@150898.advancedmd-direct.com

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279411200000",
    "number": "1063493823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 RITCHIE HWY",
            "address_2": "STE F",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122742",
            "telephone_number": "410-757-2077",
            "fax_number": "410-757-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 OLD SOLOMONS ISLAND RD",
            "address_2": "STE 303",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013854",
            "telephone_number": "410-573-1944",
            "fax_number": "410-573-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "STACEY",
        "middle_name": "JEAN",
        "credential": "LCSWC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2010-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "08288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth M Gwynn, RN
• Jennifer Helaine Marie Haase, M.D.
• Olimatu Iye Habib, DNP, CRNP, FNP, CPN
• James B. Haddock, M.D.
• Eric Hadhazy
• Faith Hagerty, M.P.T.
• Shelby Haggerty
• Christian Michael Hague, MD
• Elizabeth Anne Hahn, MD
• Gina Decaro Hahn, DPT

• Social Worker in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.