Individual provider Active NPI

Stacy Lynn Garton, LCSW

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1114104098
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005864A Issued in IN
Practice address
919 E Jefferson Blvd
Suite 401
South Bend, IN 46617-3112
Phone
(574) 287-4197
Fax
(574) 287-4393
NPI assigned
Jan 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 255048 KY
Clinical Social Worker 1041C0700X L13060 OR
Clinical Social Worker 1041C0700X 34005864A IN Primary

Addresses

Primary practice location

919 E Jefferson Blvd
Suite 401
South Bend, IN 46617-3112

Mailing address

3516 E Jefferson Blvd
Suite 401
South Bend, IN 46615-3034
Phone (574) 287-4197

Other names 1

  • Miss Stacy Lynn Mayner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240521003458 OH Practitioner - Clinical Social Worker 5597933069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
255048KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Health Or DS, LLC CurrentSince Aug 17, 2025 Accepting new patients

Locations

1125 17th St
Ste 1000
Denver, CO 80202
Phone (855) 962-4638

1600 Stout St
Ste 2000
Denver, CO 80202
Phone (720) 240-5760

240 N Broadway
Ste 208
Portland, OR 97227
Phone (503) 604-9111

Interoperability endpoints

  • Direct secure messaging: stacy.garton@1067223548755972.direct.elationemr.com

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": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1114104098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 E JEFFERSON BLVD",
            "address_2": "SUITE 401",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153034",
            "telephone_number": "574-287-4197",
            "fax_number": "574-287-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 E JEFFERSON BLVD",
            "address_2": "SUITE 401",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173112",
            "telephone_number": "574-287-4197",
            "fax_number": "574-287-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTON",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255048",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L13060",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005864A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "MAYNER",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.