Stacy Gayle York Nation, LCSW
Individual provider Active NPI Clinical Social Worker · Granby, CO
NPI 1114097631 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1114097631
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2073 (CO)
- Practice address
- 149 4TH Street
Granby, CO 80446-0591 - Phone
- (720) 295-4015
- Fax
- (888) 377-6720
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1509 | WY | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Ridge Counseling LLC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1509 | WY | |
| Clinical Social Worker | 1041C0700X | 2073 | CO | Yes |
Addresses
Primary practice location
149 4TH Street
Granby, CO 80446-0591
Mailing address
149 4TH Street
PO Box 591
Granby, CO 80446-0591
Phone (720) 295-4015
Other practice location 1
1705 Albany Ave
Cheyenne, WY 82001-5027
Phone (406) 860-4918
Other providers in Granby, CO
- Luna Counseling, LLC
- Jeff Thomas Marlor
- Thomas Jay Marquardt
- Jessica Lauren Morse
- Mountainland Therapy & Associates PC
- Nervepro
- New Life Chiropractic, Kinesiology and Acupuncture
- Amanda Parsons
- Alexi Kimball Perkins
- Richard J. Pfeiffer
All providers in Granby, CO · Clinical Social Worker in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.