Individual provider Active NPI

Stacey Decore, LSW

  • Social Worker
  • Somers Point, NJ
National Provider Identifier
1063840593
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL05846200 Issued in NJ
Practice address
100 Medical Center Way
Somers Point, NJ 08244-2300
Phone
(609) 653-3974
NPI assigned
Oct 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL05846200 NJ Primary

Addresses

Primary practice location

100 Medical Center Way
Somers Point, NJ 08244-2300

Mailing address

100 Medical Center Way
Somers Point, NJ 08244-2300

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
44SL05846200NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1063840593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER WAY",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER WAY",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442300",
            "telephone_number": "609-653-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECORE",
        "first_name": "STACEY",
        "name_prefix": "Ms.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05846200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.