Active NPI
Stacy L Wolff, LCSW
- Clinical Social Worker
- Dahlonega, GA
National Provider Identifier
1104977412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW002651
- Practice address
- 487 Morrison Moore Pkwy W
Dahlonega, GA 30533-1422 - Phone
- (706) 344-8461
- Fax
- (706) 348-6065
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW002651 | GA | Primary |
Addresses
Primary practice location
487 Morrison Moore Pkwy W
Dahlonega, GA 30533-1422
Mailing address
487 Morrison Moore Pkwy W
Dahlonega, GA 30533-1422
Phone (706) 344-8461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374813915A | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW002651 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241654400000",
"number": "1104977412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "487 MORRISON MOORE PKWY W",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305331422",
"telephone_number": "706-344-8461",
"fax_number": "706-348-6065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "487 MORRISON MOORE PKWY W",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305331422",
"telephone_number": "706-344-8461",
"fax_number": "706-348-6065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFF",
"first_name": "STACY",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2009-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW002651",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "374813915A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dahlonega, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.