Stephanie Theresa Gagnon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904003494 Issued in VA

Practice address

821 W 21St St Ste 209
Norfolk, VA 23517-1500

Phone

(757) 280-1777

Fax

(757) 585-3521

NPI assigned

Mar 27, 2007

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

Enrolled in VA

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

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bold Ruler LLCGroup PAC ID 2961833116, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bold Ruler, LLC

  dba Summit Counseling Services

  • Professional Counselor
  • Norfolk, VA
  • NPI 1316404544

  Clinical

  Medicare reassignment Care Compare group NPD
• Sentara Employee Assistance Program

  • Health Maintenance Organization
  • Virginia Beach, VA
  • NPI 1245458678
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1063530145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 GERSHWIN DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234546768",
            "telephone_number": "757-646-4140",
            "fax_number": "757-585-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W 21ST ST STE 209",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235171500",
            "telephone_number": "757-280-1777",
            "fax_number": "757-585-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "STEPHANIE",
        "middle_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Gabriner, ATC, OTC
• Kathleen Marie Gabris, LPC
• Barbara A Gaddy, LPC
• Martha Mary Gadek
• Lara E Gagliardi, DO
• Rajaat Gahlon, M.D.
• Gail D. Steckler, D.O., P.C.
• Octasia Nikkole Gainer, LPC
• Beulah Monique Gaines
• Gait Center Hampton Roads

• Clinical Social Worker in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.