Staci Jo Carpenter, LISW
Individual provider Active NPI Clinical Social Worker · Grayson, KY
NPI 1124495098 · NPPES record last updated Feb 2, 2026
Key facts
- NPI
- 1124495098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I.2607648 (OH)
- Practice address
- 13399 State Highway 2
Grayson, KY 41143-8640 - Phone
- (606) 713-3853
- NPI assigned
- Aug 27, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.2607648 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aligned-Mind Counseling Services | Current |
Accepting new patients |
Interoperability endpoints
- staci.carpenter.p1@direct.thecounselingcenter.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7394 | KY | |
| Clinical Social Worker | 1041C0700X | I.2607648 | OH | Yes |
Addresses
Primary practice location
13399 State Highway 2
Grayson, KY 41143-8640
Mailing address
13399 State Highway 2
Grayson, KY 41143-8640
Phone (606) 713-3853
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0334428 | Medicaid | OH | |
| 7100620870 | Medicaid | KY |
Other names
- Staci Menix
Other providers in Grayson, KY
- Veronica Lynn Burton
- Sherry Bush
- Timothy Bush
- Cody Douglas Campbell
- Crystal Cantrell
- Taunya Carpenter
- Brad Carper
- Mark Kristan Carroll
- Carter Co Emergency Ambulance Service District
- Carter County Board of Education
All providers in Grayson, KY · Clinical Social Worker in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.