Individual provider Active NPI

Stacey Eve Guss, LCSW

  • Clinical Social Worker
  • Medford, OR
National Provider Identifier
1073722682
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2030 Issued in OR
Practice address
14 Cottage St
Medford, OR 97504-7332
Phone
(541) 779-2390
Fax
(541) 779-3260
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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 2030 OR Primary

Addresses

Primary practice location

14 Cottage St
Medford, OR 97504-7332

Mailing address

14 Cottage St
Medford, OR 97504-7332
Phone (541) 779-2390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20050823000883 OR Practitioner - Clinical Social Worker 5193756765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14 Cottage St
Medford, OR 97504-7332
Phone (541) 779-2390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2030ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Stacey Guss LCSW LLC Clinical CurrentSince Mar 11, 2011 Accepting new patients

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1073722682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 COTTAGE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047332",
            "telephone_number": "541-779-2390",
            "fax_number": "541-779-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 COTTAGE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047332",
            "telephone_number": "541-779-2390",
            "fax_number": "541-779-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSS",
        "first_name": "STACEY",
        "middle_name": "EVE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "2030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.