Individual provider Active NPI

Grace Hayes Stuckey, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1104949296
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26667 Issued in CA
Practice address
7601 Hospital Way
Ste 220
Sacramento, CA 95823
Phone
(916) 737-5555
Fax
(916) 689-8943
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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 26667 CA Primary

Addresses

Primary practice location

7601 Hospital Way
Ste 220
Sacramento, CA 95823

Mailing address

777 12TH Street
Sacramento, CA 95814
Phone (916) 469-4690

Other identifiers 1

IdentifierTypeStateIssuer
8930OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26667CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspace Health Current Accepting new patients
Wellspace Health CurrentSince Aug 1, 2023 Accepting new patients
Wellspace Health CurrentSince Aug 1, 2023 Accepting new patients
Wellspace Nexus PastSince Dec 6, 2022 Accepting new patients

Locations

7601 Hospital Dr
Ste 220
Sacramento, CA 95823
Phone (916) 689-3433

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

1820 J St
Sacramento, CA 95811
Phone (916) 550-5481

Organizations & group practices 4

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1104949296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 12TH STREET",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95814",
            "telephone_number": "916-469-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 HOSPITAL WAY",
            "address_2": "STE 220",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95823",
            "telephone_number": "916-737-5555",
            "fax_number": "916-689-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "GRACE",
        "middle_name": "HAYES",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "26667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "8930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.